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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 7, 879-886.
doi: 10.1302/0301-620X.89B7.18981  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Revision total hip replacement using cemented collarless double-taper femoral components

D. W. Howie, PhD, MBBS, FRACS, Professor, Head of Department and Clinical Director1; J. A. Wimhurst, MChir, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon2; M. A. McGee, BSc, MPH, Senior Medical Scientist1; T. A. Carbone, BSc, Research Assistant1; and B. S. Badaruddin, MD, MS(Orth), AM, Consultant Orthopaedic Surgeon, Head of Joint Reconstruction and Replacement Unit3

1 Department of Orthopaedics and Trauma, Royal Adelaide Hospital and Discipline of Orthopaedics and Trauma, University of Adelaide, Level 4 Bice Building, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
2 Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospital NHS Trust, Colney Lane, Norwich NR4 7UY, UK.
3 Joint Reconstruction Replacement Unit, Institute of Orthopaedics and Traumatology, Hospital Kuala Lumpur, 50586 Kuala Lumpur, Malaysia.

Correspondence should be sent to Professor D. W. Howie; e-mail: donald.howie{at}adelaide.edu.au

We investigated 219 revisions of total hip replacement (THR) in 211 patients using a collarless double-taper cemented femoral component. The mean age of the patients was 72 years (30 to 90). The 137 long and 82 standard length stems were analysed separately. The mean follow-up was six years (2 to 18), and no patient was lost to follow-up.

Survival of the long stems to re-revision for aseptic loosening at nine years was 98% (95% confidence interval (CI) 94 to 100), and for the standard stems was 93% (95% CI 85 to 100). At five years, one long stem was definitely loose radiologically and one standard stem was probably loose. Pre-operative femoral bone deficiency did not influence the results for the long stems, and corrective femoral osteotomy was avoided, as were significant subsidence, major stress shielding and persistent thigh pain.

Because of these reliable results, cemented long collarless double-taper femoral components are recommended for routine revision THR in older patients.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General