Complications with revision of the femoral component of total hip arthroplasty. Comparison between cemented and uncemented techniques

The intraoperative and early postoperative complications of femoral component revision surgery in a group of 94 treated with a cemented femoral implant and 91 treated with a specific (Bias, Zimmer International, Warsaw, IN) uncemented femoral implant were assessed. Follow-up of at least 2 years for both groups was obtained, averaging 4.5 years and 3.2 years, respectively. The Harris hip score was 45 and 81 before and after the cemented revision and 42 and 84 for the uncemented procedure. The overall complication rate was 41% and 34%, respectively, which is not statistically different. The major differences consist of radiographic evidence of probable loosening in 53% of the cemented population and at least 2 mm of subsidence in 45% of the uncemented group. Fracture occurred in 3% and 18%, respectively, and caused failure in one with cemented and three with uncemented revisions. The reoperation rate was 15% and 12%, respectively. In these patient populations, uncemented femoral revision was a satisfactory technique, having a complication rate comparable to and radiographic features more favorable than what was present with the cemented revision procedure. Long-term follow-up is necessary to determine more fully the role of uncemented implants for femoral component revision.