Outcome After Femoral Revision Using the Restoration Cone/conical Femoral Revision Stem

Authors:
  • JMJanet McCaul
    Janet McCaul
  • BJBryn Jones
    Bryn Jones
  • RIRoland Ingram
    Roland Ingram
  • ASAndrew Stark
    Andrew Stark
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Abstract
Despite improvements in implant technology and surgical technique, failure of total hip arthroplasty (THA) remains a persistent problem. This article reports clinical outcomes at a mean follow-up of 42 months using the Restoration cone/conical modular femoral revision stem (Stryker, Newbury, United Kingdom). A prospective cohort study was performed of 46 consecutive patients who underwent revision THA between January 2004 and June 2007. Patients were reviewed pre- and postoperatively at regular intervals for clinical and radiological assessment. Forty-six patients (17 men, 29 women) with a mean age of 72 years (range, 44–93 years) were observed for a mean of 42 months (range, 28–66 months). Indications for surgery included aseptic loosening/osteolysis (38/46 [83%]), periprosthetic fracture (4/46 [9%]), and infection (4/46 [8%]). Median time from index procedure was 16 years (range, 1–26 years). No patient was lost to follow-up. Two patients (4%) with well-fixed asymptomatic stems died during follow-up. Three patients (7%) sustained an early postoperative dislocation. One patient sustained a periprosthetic fracture after a fall. This was treated by osteosynthesis, and stem revision was not required. Mean Oxford Hip Score improved from 42 points (range, 24–57 points) to 28 points (range, 18–51 points) at 3-month follow-up ( P =.003). Median stem subsidence was 1.0 mm (standard error of the mean, ±1.7 mm; range, 0–7mm) at last follow-up. No patient developed loosening or osteolysis around the stem. The Restoration femoral revision system has favorable clinical and radiological outcomes at a mean follow-up of 42 months.

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