The Outcome of Extensively Porous Coated Stems for Revision Total Hip Arthroplasty

During the past 30 years, we have routinely used distal diaphyseal fixation achieved with cylindrical, extensively porous-coated stems for femoral revision. We report survivorship data for 1000 cementless femoral revision arthroplasties performed at our institution between 1980 and 2010 using this technique. To implant the stems, we attempted to achieve 5-7 cm of scratch fit in the distal diaphyseal segment. Kaplan–Meier survivorship was 94.5 ± 2.3% at 15 years when femoral rerevision for any reason was used as an end point. We have had 27 stems undergo rerevision: 14 for aseptic loosening, 7 for implant fracture, 4 for infection, and 2 in conjunction with periprosthetic femoral shaft fractures. Bypassing proximal defects with the use of distal ingrowth fixation is a durable and reliable option in the revision setting.