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Revision of the Femoral Component Using Cement Fixation

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Revision Total Hip Arthroplasty

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Abstract

During the first fifteen years that total hip arthroplasty was performed extensively in the United States (1970–1985), revision surgery was limited because most primary procedures were done in older inactive patients and the time in service of most devices had been limited. Even at the Hospital for Special Surgery, by 1983 just over 250 revision procedures had been performed.1 The studies of cemented revision total hip arthroplasty performed during the early evolution of revision hip surgery were not encouraging.1–29 Pellicci et al.18 demonstrated a 19% incidence of rerevision (18% femoral side), and a 29% incidence of loosening in revision cases followed for an average of 8.1 years. Results were more discouraging in patients who had required multiple revisions, with Kavanagh and Fitzgerald30 reporting 50% clinical or radiographic failure at 3-year follow-up. In addition to a high incidence of aseptic rerevision, the early reports of revision surgery demonstrated a high incidence of complications when compared to primary cemented arthroplasty. Femoral canal perforation rates ranged from 4% to 13%. Femoral fracture rates ranged from 2.1% to 8%. Dislocation rates ranged from 8% to 10.6%. Infection rates ranged from 1.2% to 3.4%. Nerve injury rates ranged from 5% to 7%. Trochanteric problems ranged from 6.2% to 12.7% (Table 27.1).

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References

  1. Callaghan JJ, Salvati EA, Pellicci PM, Wilson PDJ, Ranawat CS. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg Am. 1985;67:1074–1085.

    PubMed  CAS  Google Scholar 

  2. Ballard W, Callaghan J, Johnston R. Revision of total hip arthroplasty in octogenarians. J Bone Joint Surg Am. 1995; 77:585–589.

    PubMed  CAS  Google Scholar 

  3. Callaghan JJ. Total hip arthroplasty. Clinical perspective. Clin Orthop. 1992;276:33–10.

    PubMed  Google Scholar 

  4. Eftekhar NS, Smith DM, Henery JH, Stinchfield FE. Revision arthroplasty using Charnley low friction arthroplasty technique. With reference to specifics of technique and comparison of results with primary low friction arthroplasty. Clin Orthop. 1973;95:48–59.

    PubMed  Google Scholar 

  5. Ejsted R, Olsen NJ. Revision of failed total hip arthroplasty. J Bone Joint Surg Br. 1987;69:75.

    Google Scholar 

  6. Engelbrecht DJ, Weber FA, Sweet MB, Jakim I. Long-term results of revision total hip arthroplasty. J Bone Joint Surg Br. 1990;72:41–45.

    PubMed  CAS  Google Scholar 

  7. Garcia-Cimbrelo E, Munuera L, Diez-Vazquez V. Long term results of aseptic cemented Charnley revisions. J Arthroplasty. 1995(April);10:121–131.

    Article  PubMed  CAS  Google Scholar 

  8. Hunter GA, Welsh RP, Cameron HU, Bailey WH. The results of revision of total hip arthroplasty. J Bone Joint Surg Br. 1994;76:419–422.

    Google Scholar 

  9. Iorio R, Eftekhar NS, Kobayashi S, Grelsamer RP. Cemented revision of failed total hip arthroplasty. Survivorship analysis. Clin Orthop. 1995;316:121–130.

    PubMed  Google Scholar 

  10. Izquierdo RJ, Northmore-Ball MD. Long-term results of revision hip arthroplasty-survival analysis with special reference to the femoral component. J Bone Joint Surg Br. 1994;76:34–39.

    PubMed  CAS  Google Scholar 

  11. Kershaw CI, Atkins RM, Dodd CAF, Bulstrods CJK. Revision total hip arthroplasty for aseptic failure: a review of 276 cases. J Bone Joint Surg Br. 1991;73:564–568.

    PubMed  CAS  Google Scholar 

  12. Marti RK, Schuller HM, Besselaar PP, Vanfrank Haasnoot EL. Results of revision of hip arthroplasty with cement. A five to fourteen-year follow-up study. J Bone Joint Surg Am. 1990;72:346–354.

    PubMed  CAS  Google Scholar 

  13. Michelson JD, Riley LH, Jr. Considerations in the comparison of cemented and cementless total hip prosthesis. J Arthroplasty. 1989;4:327–334.

    Article  PubMed  CAS  Google Scholar 

  14. Morrey BF, Kavanagh BF. Complications with revision of the femoral component of total hip arthroplasty. Comparison between cemented and uncemented techniques. J Arthroplasty. 1992;7:71–79.

    Article  PubMed  CAS  Google Scholar 

  15. Pellicci PM, Salvati EA, Robinson HJ. Mechanical failures in total hip replacement requiring reoperation. J Bone Joint Surg Am. 1979;61:28–36.

    PubMed  CAS  Google Scholar 

  16. Pellicci PM, Wilson PD, Sledge CB, et al. Revision total hip arthroplasty. Clin Orthop. 1982;170:34–41.

    PubMed  Google Scholar 

  17. Pellicci PM, Wilson PDJ, Sledge CB, Salvati EA, Ranawat CS, Poss R, et al. Long-term results of revision total hip replacement. A follow-up report. J Bone Joint Surg Am. 1985;67:513–516.

    PubMed  CAS  Google Scholar 

  18. Kavanagh BF, Fitzgerald RH, Jr. Multiple revisions for failed total hip arthroplasty not associated with infection. J Bone Joint Surg Am. 1987;69:1144–1149.

    PubMed  CAS  Google Scholar 

  19. Retpen JB, Varmarken JE, Jensen JS. Survivorship analysis of failure pattern after revision total hip arthroplasty. J Arthroplasty. 1989;4:311–317.

    Article  PubMed  CAS  Google Scholar 

  20. Retpen JB, Varmarken JE, Sturup J, Olsen C, Solund K, Jensen JS. Clinical results after revision and primary total hip arthroplasty. J Arthroplasty. 1989;4:297–302.

    Article  PubMed  CAS  Google Scholar 

  21. Retpen JB, Jensen JS. Risk factors for recurrent aseptic loosening of the femoral component after cemented revision. J Arthroplasty. 1993;8:471.

    Article  PubMed  CAS  Google Scholar 

  22. Snorrason F, Karrholm J. Early loosening of revision hip arthroplasty: a roentgen stereophotogrammetric analysis. J Arthroplasty. 1990;5:217.

    Article  PubMed  CAS  Google Scholar 

  23. Stromberg CN, Herberts P, Ahnfeit L. Revision total hip arthroplasty in patients younger than 55 years old. Clinical and radiographic results after 4 years. J Arthroplasty. 1988; 3:47–59.

    Article  PubMed  CAS  Google Scholar 

  24. Stromberg CN, Herberts P. A multicenter 10-year study of cemented revision total hip arthroplasty in patients younger than 55 years old. A follow-up report. J Arthroplasty. 1994; 9:595–601.

    Article  PubMed  CAS  Google Scholar 

  25. Stromberg CN, Herberts P, Palmertz B. Cemented revision hip arthroplasty. A multi-center 5–9 year study for 204 first revisions for loosening. Acta Orthop Scand. 1992;63:111–119.

    Article  PubMed  CAS  Google Scholar 

  26. Turner RH, Mattingly DA, Scheller A. Femoral revision total hip arthroplasty using a long-stem femoral component. Clinical and radiographic analysis. J Arthroplasty. 1987;2:247–258.

    Article  PubMed  CAS  Google Scholar 

  27. Wilson PD. Revision total hip arthroplasty: current role of polymethylmethacrylate. Clin Orthop. 1987;225:218–228.

    PubMed  Google Scholar 

  28. Wirta J, Eskola A, Hoikka V, Honkanen V, Lindholm S, Santavirta S. Revision of cemented hip arthroplasties. 101 hips followed for 5 (4–9) years. Acta Orthop Scand. 1993; 64:263–267.

    Article  PubMed  CAS  Google Scholar 

  29. Wirta J, Eskola A, Santavirta S, Tallroth K, Konttinen YT, Lindholm S. Revision of aggressive granulomatous lesions in hip arthroplasty. J Arthroplasty. 1990;5:S47–52.

    Article  PubMed  Google Scholar 

  30. Barrack R, Mulroy R, Harris W. Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review. J Bone Joint Surg Br. 1992;74:385–389.

    CAS  Google Scholar 

  31. Estok D, Harris W. Long-term results of cemented femoral revision surgery using second-generation techniques: an average 11.7-year follow-up evaluation. Clin Orthop. 1994;299:190–202.

    PubMed  Google Scholar 

  32. Harris WH, McCarthy JC, O’Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am. 1982;64:1063–1067.

    PubMed  CAS  Google Scholar 

  33. Harris WH, McGann WA. Loosening of the femoral component after use of the medullary-plug cementing technique. Follow-up note with a minimum five-year follow-up. J Bone Joint Surg Am. 1986;68:1064–1066.

    PubMed  CAS  Google Scholar 

  34. Katz R, Callaghan J, Sullivan P, Johnston R. Results of cemented femoral revision total hip arthroplasty using improved cementing techniques. Clin Orthop. 1995;319:178–183.

    PubMed  Google Scholar 

  35. Mulroy WF, Harris WH. Revision total hip arthroplasty with use of so-called second generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study. J Bone Joint Surg Am. 1996;78:325–330.

    PubMed  CAS  Google Scholar 

  36. Mulroy RD, Jr., Harris WH. The effect of improved cementing techniques on component loosening in total hip replacement. An 11-year radiographic review. J Bone Joint Surg Br. 1990;72:757–760.

    PubMed  Google Scholar 

  37. Oh I, Bourne RB, Harris WH. The femoral cement compactor. An improvement in cementing technique in total hip replacement. J Bone Joint Surg Am. 1983;65:1335–1338.

    PubMed  CAS  Google Scholar 

  38. Pierson JL, Harris WH. The effect of second generation techniques on the longevity of fixation in revision cemented femoral arthroplasties. Average 8.8 year follow-up. J Arthroplasty. 1995;10:581–591.

    Article  PubMed  CAS  Google Scholar 

  39. Raut W, Siney PD, Wroblewski BM. Cemented revision Charnley low-friction arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Br. 1994;76:909–911.

    PubMed  CAS  Google Scholar 

  40. Raut W, Siney PD, Wroblewski BM. Revision for aseptic stem loosening using the cemented Charnley prosthesis. J Bone Joint Surg Br. 1995;77:23–27.

    PubMed  CAS  Google Scholar 

  41. Raut W, Wroblewski BM, Siney PD. Revision hip arthroplasty. Can the octogenarian take it? J Arthroplasty. 1993;8:401–403.

    Article  PubMed  CAS  Google Scholar 

  42. Rubash HE, Harris WH. Revision of non-septic, loose, cemented femoral components using modern cementing techniques. J Arthroplasty. 1988;3:241–248.

    Article  PubMed  CAS  Google Scholar 

  43. Weber K, Callaghan J, Goetz D, Johnston R. Revision of a failed cemented total hip prosthesis with insertion of an acetabular component without cement and a femoral component with cement—A five to eight-year follow-up study. J Bone Joint Surg Am. 1996;78:982–994.

    PubMed  CAS  Google Scholar 

  44. Dohmae Y, Bechtold JE, Sherman RE, Puno RM, Gustilo RB. Reduction in cement-bone interface shear strength between primary and revision arthroplasty. Clin Orthop. 1988;236:214–220.

    PubMed  Google Scholar 

  45. Fornasier VL, Cameron HU. The femoral stem/cement interface in total hip replacement. Clin Orthop. 1976;116:248–252.

    PubMed  Google Scholar 

  46. Panjabi M, Trumble J, Huit E, Southwick W. Effect of femoral stem length on stress raisers associated with revision hip arthroplasty. J Orthop Res 1985;3:447–455.

    Article  PubMed  CAS  Google Scholar 

  47. Klein AH, Rubash HE. Femoral windows in revision total hip arthroplasty. Clin Orthop. 1993;291:164–170.

    PubMed  Google Scholar 

  48. Shepherd BD, Turnbull A. The fate of femoral windows in revision joint arthroplasty. J Bone Joint Surg Am. 1989;71: 716–718.

    PubMed  CAS  Google Scholar 

  49. Greenwald AS, Narten NC, Wilde AH. Points in the technique of recementing in the revision of an implant arthroplasty. J Bone Joint Surg Br. 1978;60:107–110.

    PubMed  CAS  Google Scholar 

  50. Lynch M, Esser MP, Shelley P, et al. Deep infection in Charnley low-friction arthroplasty: comparison of plain and gentamycin-loaded cement. J Bone Joint Surg Br. 1987; 69:355–360.

    PubMed  CAS  Google Scholar 

  51. Burke DW, Gates EI, Harris WH. Centrifugation as a method of improving tensile and fatigue properties of acrylic bone cement. J Bone Joint Surg Am. 1984;66:1265–1273.

    PubMed  CAS  Google Scholar 

  52. Davies JP, Harris WH. Optimization and comparison of three vacuum mixing systems for porosity reduction of Simplex P cement. Clin Orthop. 1990;254:261–269.

    PubMed  Google Scholar 

  53. Davies JP, Burke DW, O’Connor DO, Harris WH. Comparison of the fatigue characteristics of centrifuged and uncentrifuged Simplex P bone cement. J Orthop Res 1987;5:366.

    Article  PubMed  CAS  Google Scholar 

  54. Davies JP, O’Connor DO, Burke DW, Jasty M, Harris WH. The effect of centrifugation on the fatigue life of bone cement in the presence of surface irregularities. Clin Orthop. 1988;229:156–161.

    PubMed  Google Scholar 

  55. Davies JP, Jasty M, O’Connor DO, Burke DW, Harrigan TP, Harris WH. The effect of centrifuging bone cement. J Bone Joint Surg Br. 1989;71:39–42.

    PubMed  CAS  Google Scholar 

  56. Wixson RL, Lautenschlager EP, Novak M. Vacuum mixing of methylmethacrylate bone cement. Trans Orthop Res Soc. 1985;10:327.

    Google Scholar 

  57. Crowninshield RD, Brand RA, Johnston RC, Milroy JC. An analysis of femoral component stem design in total hip arthroplasty. J Bone Joint Surg Am. 1980;62:68–78.

    PubMed  CAS  Google Scholar 

  58. Crowninshield RD, Brand RA, Johnston RC, Milroy JC. The effect of femoral stem cross-sectional geometry on cement stresses in total hip reconstruction. Clin Orthop. 1980;146:71–77.

    PubMed  Google Scholar 

  59. Harris WH, Allen JR. The calcar replacement femoral component for total hip arthroplasty: design uses and surgical technique. Clin Orthop. 1981;157:215–224.

    PubMed  Google Scholar 

  60. McLaughlin JR, Harris WH. Revision of the femoral component of a total hip arthroplasty with the calcar-replace-ment femoral component. Results after a mean of 10.8 years postoperatively. J Bone Joint Surg Am. 1996;78:331–339.

    PubMed  CAS  Google Scholar 

  61. McCallum J, Hozack W. Recementing a femoral component into a stable cement mantle using ultrasonic tools. Clin Orthop. 1995;319:232–237.

    PubMed  Google Scholar 

  62. Lieberman JR, Moeckel BH, Evans B, et al. Cement-within-cement revision hip arthroplasty. J Bone Joint Surg Br. 1993;75:869–871.

    PubMed  CAS  Google Scholar 

  63. Kelley SS. High hip center in revision arthroplasty. J Arthroplasty. 1994;9:503–510.

    Article  PubMed  CAS  Google Scholar 

  64. Allan DG, Lavoie G, McDonald S, et al. Proximal femoral allograft in revision hip arthroplasty. J Bone Joint Surg Br. 1991;73:235–240.

    PubMed  CAS  Google Scholar 

  65. Zmollek JC, Dorr LD. Revision total hip arthroplasty: the use of solid allograft. J Arthroplasty. 1993;8:361–370.

    Article  Google Scholar 

  66. Gie G, Linder L, Ling R, et al. Impaction cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br. 1993;75:14–21.

    PubMed  CAS  Google Scholar 

  67. Retpen JB, Varmarken JE, Rock ND, Jensen JS. Unsatisfactory results after repeated revision of hip arthroplasty: 61 cases followed for 5 (1–10) years. Acta Orthop Scand. 1992;63: 120–127.

    Article  PubMed  CAS  Google Scholar 

  68. Kavanagh BF, Ilstrup DM, Fitzgerald RH, Jr. Revision total hip arthroplasty. J Bone Joint Surg Am. 1985;67:517–526.

    PubMed  CAS  Google Scholar 

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Authors
  1. John J. Callaghan
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Editors and Affiliations

  1. New England Baptist Hospital, Boston, MA, 02120, USA

    James V. Bono M.D. , Joseph C. McCarthy M.D. , Benjamin E. Bierbaum M.D.  & Roderick H. Turner M.D. , ,  & 

  2. Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Thomas S. Thornhill M.D.

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© 1999 Springer Science+Business Media New York

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Callaghan, J.J. (1999). Revision of the Femoral Component Using Cement Fixation. In: Bono, J.V., McCarthy, J.C., Thornhill, T.S., Bierbaum, B.E., Turner, R.H. (eds) Revision Total Hip Arthroplasty. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1406-9_27

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  • DOI: https://doi.org/10.1007/978-1-4612-1406-9_27

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7131-4

  • Online ISBN: 978-1-4612-1406-9

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