Should the well-fixed, uncemented femoral components be revised during isolated acetabular revision?

The results of isolated acetabular revision performed in 35 patients (36 hips) were monitored from 3 to 10 years. All femoral components were well fixed and not removed or revised during index surgery. All revision acetabular implants were cementless, using a porous-coated hemispheric cup with or without bone graft. There were no cases of femoral component radiographic or clinical failure. For some cases, we performed bone grafting to focal osteolysis of the proximal femur around the cementless stem. Bone incorporation occurred in 12 hips (overall 14). The mean pre- and postoperative Harris Hip Scores were 49 and 80, respectively. The findings suggest that isolated acetabular revision using a cementless porous-coated hemispheric cup can be performed without removing or revising a stable, well-fixed, uncemented femoral component if there is no concern about dislocation. We demonstrated that isolated acetabular revision is feasible and that grafting to the osteolytic femoral defects is a worthwhile procedure to restore bone stock.