Long stem cemented revision arthroplasty for aseptic loosening in elderly patients produces good results, despite significant bone loss.

We assessed the results of long cemented stems in patients over 65 undergoing a first time revision hip arthroplasty for aseptic loosening. 103 patients were followed up for a minimum of five years after revision surgery; 45% had EndoKlinik C grade preoperative bone loss. At final follow-up 31 patients had died, all but one with the prosthesis in situ. There were 71 revisions alive, one had been revised for a peri-prosthetic fracture. Of the 45 that had radiographs at a minimum of five years, three stems were probably or definitely loose according to the Harris classification. There was 92% patient satisfaction and a mean Oxford Hip Score (OHS) of 25/60 in the 59 patients that had not been revised and had full clinical follow-up. Long-stem cemented revisions for aseptic loosening in elderly patients allow immediate postoperative weight bearing and have good radiological and clinical outcomes.

Functional outcome of PFC Sigma fixed and rotating-platform total knee arthroplasty. A prospective randomised controlled trial.

The aim of this study was to determine whether there is a difference in functional outcome between the PFC Sigma fixed-bearing and rotating-platform total knee replacement systems. One hundred twenty patients were randomised to receive either a fixed-bearing or rotating-platform PFC Sigma total knee replacement. Range of movement (ROM), Oxford knee score (OKS) and Knee Society score (KSS) were assessed independently before and one year after surgery. Weight-bearing X-rays were taken immediately and one year post surgery to determine the incidence of osteolysis and loosening. At a mean follow-up of 13.4 months there was no statistically significant difference in mean ROM, OKS and KSS between the two groups. There was no evidence of osteolysis or loosening in either of the groups and no revision for infection or implant failure. This study shows that there is no statistically significant difference in functional outcome between the two types of implants at short-term follow-up.