Minimum 10-year-results of extensively porous-coated stems in revision hiparthroplasty

Obtaining predictable, stable fixation of revision femoral implants is impo rtant for the longterm success of revision hip arthroplasty. The authors re port on minimum 10 years clinical and radiographic followup of 170 patients with extensively coated cementless revision femoral components. With a ran ge of followup of 10 to 16 years and a mean of 13.2 years, a survivorship o f greater than 95% was reported. Clinically, the average Postel-D'Aubigne p ain and walking score improved from a preoperative score of 5.4 points to 1 0.8 points postoperatively. Eighty-two percent of the hips had radiographic evidence of a bone-ingrown prosthesis and 13.9% had evidence of stable fib rous fixation. Four percent of stems were unstable as seen on radiographs. Six stems were revised to larger extensively coated stems and one stem is c ausing pain and is unstable but has yet to be revised. The overall mechanic al failure rate was 4.1%. Stress shielding was greatest in patients with st ems larger than 16.5 mm and in osteoporotic bone (Dorr Type C). Nine percen t of patients had significant thigh pain including all of the patients with unstable stems. In the presence of bone loss in the proximal metaphyseal r egion of the femur, fixation of the femoral component is predictable when o ptimizing prosthetic-bone fit in the diaphyseal region of the femur using a n extensively coated femoral component.