The Effects Of Different Femoral Fixation Methods On Revision Total Hip Arthroplasty Due To Noninfectious Causes In Elderly Patients

Objective To compare the clinical efficacy of using cemented femoral prostheses with cementless ones in revision total hip arthroplasty due to noninfectious causes in elderly patients.Methods Including15cases undergoing cemented technique while21cases cementless, data collected between2005and2009was reviewed and followed up. All patients were older than70years old. The mean age of cemented group was76.60years old with the mean weight to be63.75kg. In cemented group,10were for aseptic loosening or subsidence,2for aseptic loosening with periprosthetic fracture and3for prosthesis fracture or dislocation. Meanwhile, the mean age in cementless group was78.23years old with its mean weight to be61.54kg. Regarding revision reasons, there were15for aseptic loosening or subsidence,1for aseptic loosening with periprosthetic fracture, and5for prosthesis fracture or dislocation. All patients had received Harris score estimations, UCLA score estimations, radiological assessments about prostheses stability and incidence rates of complications.Results Completed clinical and radiographic evaluations were available for patients after a mean follow-up period of64.30months with the cemented group and72.23months with the cementless group. Respectively, the average Harris Hip score after revision was68.10and improved by21.82in cemented group while it was79.09and improved by28.06in cementless group,;the mean UCLA score afterwards was19.40and went up by6.40in cemented group while it was19.54and went up for8.09in cementless group. There were no statistical differences between these two groups in neither Harris Hip scores nor UCLA scores. However, statistical difference was found in the excellent and good rate of hip function in the latest follow-up with33.33%(5cases) in the cemented group and61.90%(13cases) in the cementless group. The stability of prostheses also showed a statistical difference in radiological evaluations between11cases in cemented group and19cases in cementless group. There were no significant differences discovered in dislocation or infection with the two groups.Conclusions It shows good clinical results using cemented or cementless techniques in revision total hip arthroplasty due to noninfectious causes in elderly patients. Compared with cemented technique, cementless technique shows a better result. Therefore, cementless technique could be a better choice for the elderly patients in femoral component of revision total hip arthroplasty due to noninfectious causes.