419458

Long Cemented Femoral Stem in Hip Revision: Variables Affecting the Early Results

Article

Last updated: 29 Mar 2025

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Abstract

Background It is believed that total hip arthroplasty (THA) has made a revolution in the way of treatment of hip arthritis. With an increasing number of younger patients undergoing THA, the incidence of revision hip surgery is on the rise. Revision THA is a technically difficult procedure and associated with higher complication rates. Purpose The aim of this study was to evaluate the results of long stem femoral component in revision THA. Subjects and Methods This study included 20 patients, 15 (75%) men and five (25%) women. The mean age of 61.8 years ranging from 50 to 75 years. The right side was affected in 12 (60%) patients and the left side was affected in eight (40%) patients. Nine (45%) patients were retired employees, six (30%) were employees and five (25%) were housewives. The mean of the patients' BMI was 25.9, ranging from 20.6 to 31.2. Two (10%) patients were diabetes mellitus and two (10%) patients were hypertensive. Lateral approach was used in all patients. Indication for revision was aseptic loosening in 13 (65%) patients, septic loosening in four (20%) patients, and recurrent dislocation in three (15%) patients. The mean evaluation period was 35.75 months (range from 12 to 56 months). The patients were evaluated both clinically using Harris Hip Score (HHS) and radiologically which improved from mean of 46.2 to 78.35 points. Results Seven (35%) cases of intraoperative femoral fractures, 2 (10%) cases had dislocations, one (5%) case had superficial infection. 12 (60%) patients had the femoral stem in a neutral position, six (30%) had it in a varus position while two (10%) patients had the stem in a valgus position. As regards lucent lines around the femoral stem, nine (45%) patients had it in 1 zone, four (20%) patients in 2 zones, and one (5%) patient in 3 zones. These lines were not progressive and did not affect the clinical outcome of these patients. Significant negative correlation was found between the final Harris Hip Score and patients' BMI and Trendelenburg test. Pain and patient activity and mobility improved significantly after revision with a long stem femoral prosthesis. Conclusion Long-stem is a useful option in revision THA but with high incidence of intra and postoperative complications. Intraoperative femoral fracture is the commonest complication and usually easy to manage by cerclage wiring.

DOI

10.21608/EOJ.2025.419270

Keywords

Arthroplasty, CEMENTED, hip, Long-stem, revision

Authors

First Name

Ayman

Last Name

Soliman

MiddleName

I.

Affiliation

Department of Orthopaedic Surgery, El-Hadra Orthopaedic and Traumatology University Hospital, Alexandria University, Egypt

Email

ssssoliman@hotmail.com

City

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Orcid

-

Volume

60

Article Issue

1

Related Issue

54742

Issue Date

2025-03-01

Receive Date

2025-03-27

Publish Date

2025-03-01

Page Start

26

Page End

30

Print ISSN

1110-1148

Online ISSN

2090-9926

Link

https://eoj.journals.ekb.eg/article_419458.html

Detail API

http://journals.ekb.eg?_action=service&article_code=419458

Order

419,458

Type

Original Article

Type Code

3,432

Publication Type

Journal

Publication Title

The Egyptian Orthopaedic Journal

Publication Link

https://eoj.journals.ekb.eg/

MainTitle

Long Cemented Femoral Stem in Hip Revision: Variables Affecting the Early Results

Details

Type

Article

Created At

29 Mar 2025