Orthopedic & Muscular System: Current Research
Open Access

Abstract

Cementless Long Stem Total Hip Replacement for Revision of Failed Hemiarthroplasty

Adel Mohammad Salama and Sayed El-Etewy Soudy

Background: The total hip replacement after failure of hemiarthroplasty (unipolar or bipolar) has been associated with very high rates complications (intra- and postoperative).

Patients and Methods: Forty patients 24 males and 16 females with a mean age of 58 years (range: 48-68) had total hip arthroplasty (THA) revision of aseptic loosening of hip hemiarthroplasty. The mean duration of the follow-up was 42 months (range: 30-72), and the cases lost in follow up were excluded from the study. Failure was defined as revision arthroplasty or radiographic evidence of stem loosening, indicated by an Engh fixation score ≤ 10. Vertical femoral migration of >5 mm was defined as subsidence. Harris Hip Score (HHS), and the Merle d'Aubigne (MDA) score (21) were used for patients evaluation.

Results: Clinically, the mean preoperative HHS was improved significantly from 41 (24-56) preoperative to 89 (79-96) points at the last follow up. None of our patients had thigh pain postoperatively. Thirty two patients (80%) patients who had isolated groin pain preoperatively experienced no pain postoperatively, and eight patients had partial improvement. The proximal bone remodeling was recorded on serial X-rays at the last visit compared to the first postoperative radiographs and classified as type A, two cases, type b, 22 cases, and type C, 16 cases.

Conclusion: The cement less modular distal locking total hip replacement for revision of failed hemiarthroplasty is successful as regard the clinical and radiological results. The surgeon should care of the possibility of intraoperative complications like fractures and perforations.