Revision after failed femoral components maybe technically demanding due to loss of peri-prosthetic bone. This retrospectivestudy evaluated the long-term results of femoral revision usingthe cementless Wagner Self-Locking stem. Between 1992 and 1998,68 consecutive hips in 66 patients underwent femoral revision usingthis implant. A total of 25 patients died from unrelated causeswithout further revision; the remaining 41 hips in 41 patients (12 menand 29 women) with a mean age of 61 years (29 to 80) were reviewedat a mean follow-up of 13.9 years (10.4 to 15.8). A transfemoralapproach was used in 32 hips. A total of five stems required furtherrevision because of infection in two, progressive subsidence intwo and recurrent dislocation in one. Four hips had dislocated andeight stems had subsided ≥?10?mm. The mean Harris hip score improvedfrom 33 points pre-operatively to 75 points at final follow-up (p< 0.001). In all, 33 stems (91.7%) showed radiological signsof stable bone fixation. The cumulative survival rates at 15.8 yearswith femoral revision for any reason and for stem failure as theendpoints were 92.0% (95% confidence interval (CI) 86.0% to 98.4%)and 96.6% (95% CI 92.2% to 100%), respectively. The survivorshipwith revision and ≥ 10 mm migration of the stem as the endpointwas 83.6% (95% CI 76.6% to 91.4%).This study shows quite good survival and moderate clinical outcomewhen using a monoblock tapered titanium stem for supporting theregeneration of bone in complex revision hip surgery.
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