Risk factors for recurrent aseptic loosening of the femoral component after cemented revision |
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| Affiliation: | 1. Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland;2. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio;1. University of Michigan, Department of Biomedical Engineering, Ann Arbor, MI, 48109, USA;2. Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, FDA, Silver Spring, MD, 20993, USA;1. Centre hospitalier d''Aubagne, Edmond Garcin, Hôpital d''Aubagne, Aubagne, France;2. Service de Chirurgie Orthopédique et Traumatologique, CHRU de Brest, Brest, France;3. Laboratoire de Traitement de l’Information Médicale, LaTIM UMR 1101 INSERM UBO, Brest, France;4. Université de Bretagne Occidentale, Faculté de Médecine, Brest, France;1. Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, United Kingdom;2. Royal Free Hospital NHS Trust, London, United Kingdom;1. Sunshine Bone and Joint Institute, Sunshine Hospital, Penderghast Road, PG Road, Opposite Parsi Dharamsala, Paradise, Secunderabad, 500003, Telangana, India;2. Medicover Hospitals, Madhapur, Hyderabad, India;1. Keck Hospital of the University of Southern California, Department of Orthopaedic Surgery, Los Angeles, CA, USA;2. University of California, Los Angeles, Department of Orthopaedic Surgery, Los Angeles, CA, USA;3. Memorial Sloan Kettering Cancer Center, Department of Surgery, Orthopaedic Service, New York, NY, USA |
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| Abstract: | A series of 160 consecutive cemented first revisions, performed from 1977 through 1988 for aseptic loosening of a primary cemented femoral component, were studied using survivorship methods with the purpose of identifying risk factors for recurrent loosening of the femoral component. Risk of recurrent loosening depended on the length of the revision stem, with a significantly increased risk of loosening if the tip of the primary stem was overbridged by the revision stem with less than one width of the femoral shaft. Risk of recurrent loosening was also related to the extension of a cement mantle, exceeding more than 2 mm, around the revision stem measured on postrevision anteroposterior radiographs. Furthermore, low age and neutral position of the revision stem were identified as risk factors for recurrent loosening of the cemented revision femoral component. An improved fixation of the cemented revision femoral component for revisions performed after, 1982 could be related to the use of longer revision stems and improved cementation. |
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