Proximal femoral replacement prosthesis for salvage of failed hip arthroplasty - Complications in a 2-11 year follow-up study in 19 elderly patients

We reviewed 19 elderly patients who underwent revision total hip arthroplasty with a proximal femoral replacement prosthesis for aseptic loosening and severe proximal femoral bone loss. The mean interval from initial hip replacement to revision arthroplasty was 8 (2-20) years. The mean age of the patients was 78 (63-87) years. 2 patients died within 2 years postoperatively and 1 patient was lost for follow-up evaluation. The remaining 16 patients were assessed clinically and radiographically after a mean follow-up period of 5 (2-11) years. All patients had local pain relief, but they all needed a crutch or another walking aid. According to the Merle d'Aubigne hip-rating scale there were no excellent results, 1 very good, 8 good, 5 fair, 2 poor and no bad results. 4 patients had an intraoperative fracture, 7 had a dislocation, 2 had a deep infection, and 3 patients had progressive loosening of the screws fixing the greater trochanter to the femoral component. Our series demonstrates that revision of a failed hip prosthesis, using a proximal femoral replacement prosthesis, presents complex problems.