• Kazutaka So, Yutaka Kuroda, Shuichi Matsuda, and Haruhiko Akiyama.
• Department of Orthopaedics, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan. so_kazu@kuhp.kyoto-u.ac.jp
• Arch Orthop Trauma Surg. 2013 Jun 1;133(6):869-74.

BackgroundSurgical revision after failed total hip replacement is a technically challenging procedure. The aim of this study was to analyze the long-term results of revision total hip replacement using a cemented long femoral component and identify factors that influence the results.MethodsWe retrospectively reviewed 34 hips in 33 patients who had undergone revision total hip replacement using a cemented long femoral component between 1994 and 2001. Hip function was evaluated according to the scoring system of the Japanese Orthopaedic Association. Radiographic examination was performed for evaluation of stem loosening, and its possible risk factors were investigated.ResultsThe mean follow-up duration was 11.3 years (9-15). Perioperative complications included intraoperative femoral cortex perforation (six hips, 18 %), dislocation (five hips, 15 %), deep venous thrombosis (one hip, 3 %) and postoperative periprosthetic fracture (one hip, 3 %). The mean preoperative Japanese Orthopaedic Association hip score was 50.3 ± 14.9 vs 78.2 ± 11.5 at the latest follow-up. The Kaplan-Meier survival rate at 15 years, calculated using radiological failure or re-revision of the femoral component for any reason as the end point, was 87 or 100 %, respectively. The failure-free survival rate for the subgroup with a good-quality cement mantle was significantly higher than that for the subgroup with poor quality (p = 0.033).ConclusionsThe quality of cementation was identified as a significant risk factor for further loosening. Revision total hip replacement using a cemented long femoral component yielded satisfactory long-term results in this series.

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