Six Years’ Experience in Revision Total Hip Arthroplasties with Uncemented Ceramic Prostheses

Abstract

The loosening of prosthetic components is a pressing problem in total hip arthroplasty. The reimplantation of loose total prostheses is extremely difficult. Metal sheaths, supporting rings and specially-shaped prosthetic devices have been developed in an effort to improve the attachment of revisionary prostheses. It is common for loosening to occur shortly after revisions due to the bone damage caused by removal of the primary prosthesis. Complete removal of the prosthesis followed by a Girdlestone resection is no longer regarded as an acceptable option in most patients and should at most be considered only in elderly patients with septic complications. Younger patients, who generally are still active professionally, will seldom tolerate the loss of stability and noticeable limb shortening associated with complete removal of the prosthesis.