Early failure of revision total hip arthroplasty with cemented precoated femoral components - Comparison with uncemented components at 2 to 8 years

This is a retrospective analysis of 2 methods of fixation of the femoral co mponent in 86 consecutive revision arthroplasties, for which all clinical a nd radiographic data were recorded prospectively. There were 56 cemented re visions using precoated femoral components followed for 2 to 8 years (mean, 4 years) and 30 uncemented, proximally porous-coated femoral revisions fol lowed for 2 to 6 years (mean, 4 years). Of the 56 cemented hips, 31 (55%) h ad a good or excellent clinical result. Rerevision has been performed in 10 hips, and revision of 3 loose femoral components is pending (23%). Radiogr aphic review of 56 femoral components showed that 16 (29%) had probable or definite loosening. Of 30 cementless hips, 24 (80%) had a good or excellent clinical result. There was radiographic bone ingrowth in 22 of 30 hips (73 %). Seven hips (23%) had nonprogressive subsidence, and 3 hips (10%) had pr ogressive subsidence or loosening. Rerevision has been performed in only 2 hips (7%). The high rate of loosening (29%) and rerevision (23%) at a mean follow-up of only 4 years suggests that a precoated femoral component may p lace increased stress at the already damaged bone-cement interface.