Midterm Results of Cementless Femoral Stem Revision With Wagner Cone Prosthesis

Purpose The purpose of this study is to evaluate the midterm results of cementless revision total hip arthroplasty (THA) using Wagner Cone Prosthesis. Material and Methods Between 1996 and 2007, 36 hips in 36 consecutive patients underwent femoral revision THA using Wagner Cone Prosthesis. Among them 28 hips were followed for more than 5 years. The mean age at revision surgery was 57 years and a mean follow-up was 7.6 years. The Paprosky classification system was used for preoperative bone loss evaluation. Clinical results were evaluated using Harris hip scores. For evaluation of the femoral component, radiolucent lines at bone-implant interfaces were evaluated and femoral component vertical subsidence was measured. Heterotopic bone formation and complications were also evaluated. Results The mean period from 1 st operation to revision THA was 8.0 years. For the femoral bone loss, in eleven hips bone grafting was done. For the prevention of femoral stem fracture, femoral wiring was done in 12 hips. In eighteen hips acetabular cup revision was done simultaneously and in 5 hips isolated stem revision was done. The mean Harris hip score improved from 52 to 83 at final follow-up. With respect to radiological results all femoral stems showed bone ingrowths, 3 out of 28 (10.7%) femoral stems showed subsidence more than 5 mm. Two patients needed acetabular revision for acetabular loosening during follow up period. There was one patient who complained of anterior thigh pain. One patient had recurrent dislocation and required revision surgery for soft tissue augmentation. Conclusions We achieved favorable midterm clinical and radiological results for femoral stem revisions using Wagner cone prosthesis. This cementless femoral stem can be a good option for femoral stem revision.