BACKGROUND:The uncemented prosthesis in primary total hip arthroplasty has obtained good outcomes, but its application in revision especialy in failed cemented hip arthroplasty deserves further investigations. OBJECTIVE: To observe the mid-term results of uncemented revision of failed cemented hip arthroplasty. METHODS: 41 patients (47 hips) with uncemented revision of failed cemented hip arthroplasty were folowed up from November 1997 to February 2013. In the 47 hips, 24 hips replaced the cemented stem component while 23 hips underwent the cemented acetabular revision. Prosthesis change was observed in radiographs. Harris functions were evaluated and prosthesis survival rate was analyzed. RESULTS AND CONCLUSION: A total of 33 patients (38 hips) were folowed up for 1.3-14.8 years. The mean preoperative Harris hip score increased from 34 (range, 11-66) points to 85 (range, 55-94) points at the time of final folow-up (P < 0.01). 36 hips (95%) had an excelent stability. Osteolysis and migration of the prosthesis were seen in 2 hips (1 in acetabulum and 1 in femur), which needed re-revision. Heterotopic ossification developed in 9 hips (24%). The mean polyethylene liner wear was 0.08 mm (range, 0-0.25 mm) per year. The wear rate only correlated with changes of abduction angle of the acetabulum (P < 0.01). Imaging verified that loosening served as a failure criterion. Kaplan-Meier survival analysis was used to calculate uncemented prosthesis for 7 years and showed that total survival rate was 89%. The survival rates of acetabular prosthesis and femoral prosthesis were respectively 93% and 92%. Results indicated that uncemented prosthesis could deal with the problem of bone deficiency and obtain satisfactory mid-term clinical results in revision of failed cemented hip arthroplasty.%背景：非骨水泥假体在初次人工髋关节置换中已取得了很好的疗效，但在翻修术特别是在失败的骨水泥型假体翻修过程中的应用效果仍有待观察。 目的：观察以非骨水泥假体翻修失败的骨水泥型人工髋关节的中期效果。 方法：对1997年11月至2013年2月以非骨水泥假体对失败的骨水泥型人工髋关节翻修的41例(47髋)患者进行随访，其中翻修骨水泥柄24髋、骨水泥臼23髋。随访X射线片上的假体变化情况，对髋关节行Harris功能评定并分析假体生存率。 结果与结论：共33例38髋获得随访，随访时间1.3-14.8年，患者的平均Harris评分由术前的34分(11-66分)增加到末次随访时的85分(55-94分)，差异有显著性意义(P <0.01)。36髋(95%)假体获得良好稳定性；2髋发生骨溶解并假体移位(股骨1髋，髋臼1髋)需要再翻修；9髋发生异位骨化(24%)。聚乙烯衬垫年平均磨损量为0.08 mm(0-0.25 mm)，磨损率仅与外展角变化存在相关性(P <0.01)。以影像学证明假体松动作为失败标准，利用Kaplan-Meier生存分析法计算非骨水泥假体7年总体存活率为89%，其中髋臼假体和股骨假体的存活率分别为93%及92%。提示用非骨水泥假体对失败的骨水泥型人工髋关节进行翻修能有效地修复骨缺损并达到令人满意的中期临床效果。
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