Removal of well-fixed or porous-coated cementless stems in total hip revision arthroplasty

The removal of well-fixed or porous-coated cementless stems is demanding and associated with a high perioperative risk to the patient. Only a few surgical techniques have been published about this procedure. We introduce a special, ballistically driven, flexible chisel for the disruption of bone ingrowth or fibrous encapsulation. In six cases the stem removal was successful after 8–15 min (average 12,2 min) without damage to the bone. Reimplantation is possible with standard stems for primary surgery. This surgical technique leads to a predictable procedure, reduces the risk for the patient, the operation time and costs. We are continuing with this technique under supervision by the local Ethics Commission.