The Wagner Uncemented Long-Stemmed Revision Prosthesis: Medium-Term Results for Proximal Femoral Osteolysis

This paper presents a clinical and radiological review of nineteen hips that were revised using the uncemented long stem Wagner prosthesis. All the hips were symptomatic and demonstrated proximal femoral osteolysis. The mean follow-up was 61 months: there were four hips with a follow-up of more than 4 years, eight hips with a follow-up of more than 5 years, three hips with a follow-up of over 6 years, while there were two hips with a follow-up of above 7 years. Only two hips had a follow-up of less than 4 years. The clinical results were satisfactory. 95% of patients had mild, occasional or no pain, and 90% minimal or no limitations of mobility. Radiographically, significant restoration of the proximal femoral bone stock (Pak and Paprosky classification) occurred in 42% of cases. No stems were radiographically loose. 89% of stems showed subsidence of less than 4mm. There were no re-revisions at the time of follow-up. These medium-term results support the use of the Wagner uncemented distal load bearing femoral prosthesis for difficult revision cases in the presence of symptomatic proximal femoral bone resorption. Significant stem subsidence was not encountered.