FEMORAL COMPONENT REVISION IN COMPLEX CONDITIONS IN HIPS WITH IMPORTANT BONE LOSS: EIGHT TO TWELVE YEARS FOLLOW-UP

Introduction: T.H.A. revisions are constantly increasing: and it’s known that bone defects – expecially if severe like in rirevision cases – are the main problem to manage during the revision surgery. Since 1988, we have chosen to bypass the bone defects by using an “elastic” non-invading tapered stem (SL Wagner); morsel bone graft is rarely necessary, we never use a massive one. According to our philosophy in revisioning, stability should be obtained by a diaphysary anchorage as proximal as possible. Methods: Our research concerns 150 cases of SL revision stems implanted from December ’88 to December ’91. The average age is 67 years old, complete clinical evaluation and survivorship analysis for the entire study cohort was performed from 8 to 12 years follow-up, radiographic analysis in 81 cases with 101 months avg. follow-up (min. 60 – max. 143). Results and Discussion: 4 cases required rirevision; 20 patients deceased; 12 were lost to follow-up; 96 examinated. Clinical evaluations show an average score of 78 (acc. to HHS); 82,3 percent of patients are pain free, while slight pain still persists in a 13,7 percent pain in a 3,9 percent. The radiographic analysis has put into evidence only 1 case of mobilization, and suffering bone in 4 percent of cases; by contrast, 79,5 percent show astonishing endosteal bone formation.