Cementless Revision of Total Hip Arthroplasty Using Proximal Porouscoated Femoral Implants

ABSTRACT: Thirty patients had 32 cementless total hip arthroplasty revisions and were  evaluated postoperatively for clinical function (Harris Hip Score) and radiographic evidence of  implant stability. Of the 26 femoral components revised, 16 were revised with anatomic  long-stem femoral prostheses, and 10 were revised with straight mid-stem-length components.  ll components were collared and had circumferential proximal fiber-mesh  porous coating. Seven of 16 patients had radiographic subsidence after revision with long-stem  components (2 to 30 mm); 6 of 10 patients had subsidence after revision with midstem femoral components (2 to 25 mm). Of the 13 patients with femoral subsidence, 8 had calcar  reconstruction with allograft bone; of the 13 patients without radiographic subsidence, 8 did not require calcar reconstruction. One of 27 fibermesh, porous-coated acetabular components migrated (30 mm). No components have been removed or revised. Even with circumferential proximal porous coating, femoral implant stability remains unpredictable in total hip  arthroplasty revision.