Treatment of XXXX following total hip arthroplasty with femoral component revision.

@entity1 @entity174 @entity5 @entity281 @entity3330 @entity3564
BACKGROUND: Revision total hip arthroplasty is indicated for most @entity3564 that occur around the stem of the femoral implant. The purpose of the present study was to assess the results and complications of revision total hip arthroplasty for the treatment of @entity3330 . METHODS: We evaluated 118 hips in 116 @entity1 who underwent revision total hip arthroplasty because of an acute Vancouver type-B periprosthetic @entity3330 . The femoral implant used for the revision was a cemented stem in forty-two hips, a proximally porous-coated uncemented stem in twenty-eight, an extensively porous-coated stem in thirty, and an allograft-prosthesis composite or @entity5 prosthesis in eighteen. The mean duration of follow-up was 5.4 years. RESULTS: Kaplan-Meier analysis demonstrated that the probability of survival was 90% at five years and 79.2% at ten years with revision or removal of the femoral implant for any reason as the end point. Sixteen femoral components were rerevised: ten were rerevised because of loosening; three, because of loosening in association with a @entity174 nonunion; two, because of recurrent dislocation; and one, because of a new @entity3564 . Additionally, six femoral implants were resected because of @entity281 (five) or prosthetic loosening (one). Radiographs of the ninety-six hips with a surviving implant showed that twenty-one had evidence of loosening of the femoral implant, four had a nonunion of the @entity3330 , and two had both a nonunion and loosening of the femoral implant. CONCLUSIONS: Revision total hip arthroplasty for the treatment of a @entity3564 around the stem of the femoral implant successfully restored function for most @entity1 . The greatest long-term problems were prosthetic loosening and @entity174 nonunion. Better results were seen when an uncemented, extensively porous-coated stem was used.
