Revision total hip arthroplasty with an uncemented primary stem in 79 patients

Introduction

Revision in THA continues to be a technical challenge because of difficulties in fixation of the femoral component in mostly deficient bone in the proximal femur. In cases with minor cortical defects, the use of primary stems in revision surgery has also been described by some authors.

Materials and methods

Seventy-nine patients with minor femoral bone defects were reviewed retrospectively (mean follow-up 6.8 ± 3.9 years), who underwent a femoral component revision surgery using the uncemented primary Bicontact stem (Aesculap, Tuttlingen, Germany). Furthermore, the radiographs (anteroposterior and lateral) before, after surgery and at latest follow-up were analysed concerning femoral defects, proximal bone loss, and to determine the quality of bony fixation.

Results

The average Harris hip score (HHS) was 42.2 ± 20.8 preoperative and improved to 78.9 ± 12.5 at latest follow-up (p < 0.001). Motion Score increased significantly from 2.7 ± 1.9 to 3.5 ± 1.4 (p < 0.05) and pain score decreased significantly from 5.7 ± 2.9 to 3.6 ± 2.4 (p = 0.005). During follow-up there were only four re-revisions within 2 years after revision. The results and clinical outcome of this study correspond to those published before, using primary cementless stems in cases of revision.

Conclusion

Therefore, the primary uncemented Bicontact stem appears to be a good alternative to other revision systems in well-selected femoral revision cases with minor defects.