RESULTS OF ISOLATED ACETABULAR REVISIONS - THE FATE OF THE UNREVISED FEMORAL COMPONENT

Controversy exists over whether to remove a well-fixed femoral compone nt al the time of revision of a failed acetabular component, and it ha s been suggested that the femoral component be removed and recemented. The hypothesis presented in this article is that only the acetabular component should be revised in these situations. Thirty-eight isolated , uncemented acetabular revisions were performed by 1 surgeon and pros pectively followed for a mean of 4 years (range, 2-10 years). The femo ral component was well fixed at the time of revision and left in situ. There were 30 cemented and 8 uncemented femoral components, which had been in place for a mean of 10.7 years. The hips were evaluated clini cally using the Harris hip score rating system. Radiographic evaluatio n of both components was performed using well-established criteria. Mo rselized cancellous allograft was used to fill acetabular defects in 3 0 hips, and a bulk allograft was used in 1 hip. There was a good or ex cellent clinical result in 32 hips (84%). Two cemented femoral compone nts required revision for aseptic loosening at 2.5 and 4 years. No ace tabular component migrated or was revised, and no revisions of either component are pending. Thirty-six (95%) of the unrevised femoral compo nents remain well fixed at the most recent follow-up examination. Comp ared with a similar population of hips in which both the acetabular an d femoral components were revised, the mean blood loss for these revis ions was 52% less and the mean surgical time was 35% shorter. Revision of only the acetabular component is recommended for isolated acetabul ar aseptic loosening. Because the femoral component is not removed, su rgical time and blood loss are decreased and serious potential complic ations related to removing a well-fixed femoral component can be avoid ed.