Revision of hemiarthroplasty to XXXX using the cement-in-cement technique.

@entity1 @entity174 @entity532 @entity281 @entity572 @entity1349
Revision of a cemented hemiarthroplasty of the hip may be a hazardous procedure with high rates of @entity532 . Removing well-fixed cement is time consuming and risks damaging already weak bone or perforating the femoral shaft. The cement-in-cement method avoids removal of intact cement and has shown good results when used for revision @entity572 ( @entity572 ). The use of this technique for the revision of a hemiarthroplasty to @entity572 has not been previously reported. A total of 28 consecutive hemiarthroplasties (in 28 @entity1 ) were revised to a @entity572 using an Exeter stem and the cement-in-cement technique. There were four @entity1 and 24 @entity1 ; their mean age was 80 years (35 to 93). Clinical and radiographic data, as well as operative notes, were collected prospectively and no @entity1 was lost to follow-up. Four @entity1 died within two years of surgery. The mean follow up of the remainder was 70 months (25 to 124). Intra-operatively there was one proximal perforation, one crack of the femoral calcar and one @entity174 . No femoral components have required subsequent revision for @entity1349 or are radiologically loose. Four @entity1 with late complications (14%) have since undergone surgery (two for a peri-prosthetic fracture, and one each for @entity281 and recurrent dislocation) resulting in an overall major rate of complication of 35.7%. The cement-in-cement technique provides reliable femoral fixation in this elderly population and may reduce operating time and rates of complication. Cite this article: Bone Joint J 2015;97-B:1623-7.
