A Prospective Outcomes Analysis of Femoral Component Fixation in Revision Total Hip Arthroplasty

A prospective, surgeon-allocated, matched cohort analysis of patient outcomes compared cementless, modular metaphyseal and cemented femoral fixation used for revision total hip arthroplasty. First-time femoral revision operations (with and without acetabular revision) with Paprosky types I and II femoral bone stock were included. This series of 86 patients was matched for age, weight, diagnosis, Charnley class, Demand category, femoral bone stock, and outcome measures. At 8-year average follow-up (range, 4-13 years), there were no significant differences in visual analog pain scores (VAPS), Harris Hip Scores (HSS), and SF-36 Physical Function and Bodily Pain scores. One femoral rerevision (2.3%) occurred in the cementless group, and 2 (4.6%) occurred in the cemented group (P = .557). Five-year survivorship for femoral rerevision was 94% for patients with cementless, modular metaphyseal fixation and 92% for patients with cemented fixation. In this study, cementless, modular metaphyseal fixation and cemented femoral fixation were both successful at intermediate-term follow-up in Paprosky types I and II femoral bone (level of evidence: therapeutic study; level II, prospective comparative study).