Revision Total Hip Replacement using a Cementless Wagner SL Femoral Stem

ABSTRACT

PURPOSE: To evaluate the clinical and radiological changes of femoral revision with the Wagner SL stem. MATERIALS AND METHODS: 21 femoral revisions were performed in 21 patients (16 males and 5 females; mean age 58.9 years) between June 1997 and July 2005, utilizing the Wagner SL stem. The follow-up period was a mean of 31 months (range 25-84 months). Causes of revision included aseptic loosening (14 cases), periprosthetic fracture (4 cases), recurrent total hip dislocation (2 cases), and neglected bipolar hip dislocation (1 case). Greater trochanteric osteotomy was performed in 10 cases, and extended trochanteric osteotomy was performed in 6 cases. Clinical results were assessed using Harris hip score. Radiographic parameters such as stem subsidence, calcar atrophy, and stressshielding were also assessed. RESULTS: The mean Harris hip score improved from 45.7 to 91.3. There was no removal of the implanted Wagner stem. One case of nonunion of the greater trochanter was treated by fixation with Dall-Miles cables and a trochanteric plate. There was one case of limb shortening of 2 cm. CONCLUSION: The Wagner SL stem provided immediate stability and allowed early weight-bearing. Bony regeneration around the stem was achieved without resorting to a bone graft.