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CEMENTED REVISION TOTAL HIP REPLACEMENT- REVIEW OF 100 CONSECUTIVE CASES

The Centre for Hip Surgery, Wrightington Hospital, UK

Introduction: The purpose of this study was to review the results of revision total hip replacement, using cement, done by a single surgeon in a tertiary referral centre. 164 patients underwent revision hip surgery for aseptic loosening, infection or recurrent dislocation.

Methods: 95 patients had a one stage revision, 25 patients had two stage revisions and the remainder had either the stem or socket revised. 10 patients had application of a PLAD for recurrent dislocation. Structural and morselized bone grafting was carried out in patients with extensive bone loss. 46 patients had morselized impaction bone grafting to the acetabulum. The first hundred patients with revision of both components and minimum follow up of twelve months were reviewed. Patients were routinely followed up in the clinic and assessed using the Oxford Hip Score and Merle D’Abigne scores for pain, function and range of movements. Radiographs were assessed for any demarcation or loosening.

Results: The mean age at surgery was 69.99 years (36ys to 95yrs). The mean follow up was 25 months (12 to 60 months). There were 5 dislocations, 2 wound dehiscence, 3 DVT’s and 2 deep infections in the whole group. There were 2 dislocations, 2 DVT, 1 wound dehiscence and 1 infection in the study group. The preoperative scores were available for 83 patients and the average scores for pain, function and range of movements were 3.2, 2.8 and 1.6 respectively. The average scores at the latest follow up were 5.08, 4.2 and 4.0. The mean Oxford Hip scores were 26.65. X-rays showed no demarcation in the acetabulum in 88 patients and in the femur in 92 patients. The trochanter was united in 72 patients. In 13 patients the trochanter had migrated more than 1 cm.

Conclusion: Revision total hip replacement using cement has shown good results in the short term. Cemented revisions are safe, reliable and also cost effective.

Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.