Revision of the femoral component of a total hip arthroplasty with the calcar-replacement femoral component - Results after a mean of 10.8 years postoperatively

Patients who have major loss of bone in the region of the medial aspect of the femoral neck, shortening of the limb, or a high center of the hip joint constitute a special challenge for surgeons performing revision total hip replacements. The use of a so-called calcar-replacement femoral component is one approach to these problems. Of forty-eight hips (forty-four patients) that had been treated consecutively with a total revision arthroplasty with insertion of a calcar-replacement femoral component with cement, thirty-eight hips (thirty-five patients) were followed for a mean of 10.8 years (range, 5.8 to 16.6 years), Ten of the forty-eight hips did not qualify for this study, including nine hips in eight patients who had died before the minimum five-year duration of follow-up and one hip in a patient who had refused follow-up, Of the thirty-eight hips that were followed, seven (18 per cent) had had a repeat revision because of aseptic loosening of the femoral component, one (3 per cent) had been revised again because of lysis around a well fixed femoral component, and an additional four (11 per cent) had a component that was loose according to radiographic criteria. Thus, twenty-six (68 per cent) of the thirty-eight index femoral components were rigidly fixed according to radiographic criteria, and thirty (79 per cent) were still in place. The clinical results were very good for the thirty hips that had not been revised, The mean Harris hip-rating for these patients increased from 50 points preoperatively to 84 points at the most recent follow-up evaluation.