CEMENTED TOTAL HIP-ARTHROPLASTY FOLLOWING PREVIOUS FEMORAL OSTEOTOMY - AN AVERAGE 16-YEAR FOLLOW-UP-STUDY

The indications for proximal femoral osteotomy would be substantially limited if it significantly compromised the outcome of a subsequent hi p arthroplasty. Previous reports have followed only early cementing te chniques over intermediate duration. This study comprised 22 primary c emented total hip arthroplasties performed by a single surgeon followi ng failed proximal femoral osteotomies at an average follow-up period of 15.8 years. Three patients who died prior to the 11-year minimum fo llow-up period are not included, leaving 19 hips for long-term review. All seems were cemented with second-generation techniques. Stem place ment and collar-calcar contact, however, were substantially worse comp ared with historical control subjects. Eight reconstructions required custom miniature or calcar replacement components, and in 6 hips, the stems were inserted only in the diaphysis. Two of 19 femoral component s (10.5%) were revised for aseptic loosening and 2 additional femoral components were loose. The average Harris hip score of those not revis ed was 80.4. Five acetabular components (26.3%) required revision. Fou r additional cups were loose, yielding a total acetabular loosening ra te of 47.4% at 15.5 years. Intertrochanteric osteotomy in general did not affect the expected excellent results of the femoral component usi ng modern cementing techniques. Severe deformity following subtrochant eric osteotomy, however, did adversely affect the outcome.