Journal List > J Korean Hip Soc > v.22(2) > 1048668

Kim, Cho, Hwang, Kim, and Choi: Revision Total Hip Arthroplasty Using a Wagner Revision Stem

Abstract

Purpose

We evaluated the results of revision total hip arthroplasty using a Wagner revision femoral stem.

Materials and Methods

We enrolled 54 patients who underwent hip arthroplasty using a Wagner revision stem between 1996 and 2004. The mean age at revision surgery was 65.4 years and the mean follow up period was 7.2 years. There were 42 aseptic loosenings and 12 periprosthetic fractures. The pre-operative femoral defects were classified according to the Paprosky classification system. Clinical and radiological results were evaluated.

Results

The mean Harris hip score improved from 43 preoperatively to 89 at the latest follow up. There were 2 cases with inguinal pain and 1 with thigh pain; in each case pain was reduced by medications. All cases showed endosteal bone formation around the stem. Five cases showed radiolucency in Gruen zones 1 and 7. Six cases had hips that showed subsidence (average=3.1 mm). There was 1 dislocation (1.8%) and 1 intraoperative periprosthetic fracture (1.8%). There were no re-revisions.

Conclusion

Use of a Wagner revision femoral stem for revision total hip arthroplasty elicits satisfactory results including stable fixation of the stem, a low rate of subsidence, and a low rate of dislocation.

Figures and Tables

Fig. 1
(A) Radiograph of 43-year-old man showed aseptic loosening of stem after bipolar hemiarthroplasty. (B) The immediate postoperative radiograph showed stable fixation of femoral stem. (C) Radiograph of 10.4 years after revision total hip arthroplasty demonstrated stable fixation of the Wagner stem.
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Fig. 2
(A) Radiographs of 80-year-old woman with Vancouver type B2 periprosthetic femoral fracture. (B) Immediate postoperative radiograph. (C) Radiograph of 5 year revision total hip arthroplasty showed excellent restoration of the proximal part of the femur.
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Table 1
Summary of Data of Patients in the Subsidence Group
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