scholarly journals Primary total hip arthroplasty using an uncemented Wagner SL stem in elderly patients with Dorr type C femoral bone

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ping Zhen ◽  
Jun Liu ◽  
Xusheng Li ◽  
Hao Lu ◽  
Shenghu Zhou
Keyword(s):  
Lateral View ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Bone ◽  
Stem Design ◽  
Total Hip ◽  
Tapered Stem ◽  
Type C ◽  
Hip Arthroplasties

Abstract Background The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner Self-Locking stem in patients with type C femoral bone. Methods Twenty-eight total hip arthroplasties were performed in 25 patients aged ≥ 60 years using a cementless Wagner Self-Locking femoral component between 2006 and 2011. According to Dorr’s criteria, all 28 femora were classified as type C bone. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients. Results Mean follow-up period was 125 ± 10.5 months (range 96 to 156 months). Average Harris hip score pre-operatively was 46 ± 9 (range 39 to 62) and at the last follow-up was 90 ± 9 (range 83 to 98). The stem to canal fill is calculated as percentages on the operative side at three distinct levels: just below the lesser trochanter, at midstem, and 1 cm above the tip of the component on anteroposterior radiograph. The mean proximal stem-to-canal fill percentages were 97% ± 2.1%, 95% ± 3.5%, and 88% ± 2.6%, respectively (anteroposterior view) and 92% ± 2.2%, 86% ± 1.9%, and 83% ± 2.5%, respectively (lateral view). Radiographic evaluation demonstrated good osteointegration of the implants in the follow-up. Conclusions Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of the stem and wide stovepipe femoral canal from metaphysis to diaphysis in type C bone.

scholarly journals Primary Total Hip Arthroplasty Using an Uncemented Wagner SL Stem in Elderly Patients With Dorr Type C Femoral Bone

2018 ◽  
Vol 103 (5-6) ◽  
pp. 287-294
Author(s):  
Ping Zhen ◽  
Jun Liu ◽  
Hao Lu ◽  
Hui Chen ◽  
Xusheng Li ◽  
...  
Keyword(s):  
Lateral View ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Bone ◽  
Stem Design ◽  
Total Hip ◽  
Type C ◽  
The Mean ◽  
Hip Arthroplasties

The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner self-locking stem in patients with Type C femoral bone. Twenty-five total hip arthroplasties were performed in 23 patients aged ≥60 years using a cementless Wagner self-locking femoral component between 2006 and 2011. According to Dorr's criteria, all 25 femora were classified as type C bone. Mean follow-up period was 62 months (range, 47–85 months). Average Harris Hip score preoperatively was 46 ± 9 (range, 39–62) and at the last follow-up was 90 ± 9 (range, 83–98). The mean proximal stem-to-canal fill percentage was 95% ± 3.5% (anteroposterior view) and 90% ± 2.8% (lateral view) and the mean distal canal fill was 93% ± 4.5% (anteroposterior) and 92% ± 3.9% (lateral). Radiographic evaluation demonstrated good osteointegration of the implants in follow-up. Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of stem and wide stovepipe femoral canal from metaphysis to diaphysis in Type C bone.

scholarly journals Primary Total hip Arthroplasty Using A Short Bone-Conserving Stem in Young Adult Osteoporotic Patients with Dorr type C Femoral Bone

2020 ◽  
Author(s):  
Ping Zhen ◽  
Yanfeng Chang ◽  
Heng Yue ◽  
Hui Chen ◽  
Shenghu Zhou ◽  
...  
Keyword(s):  
Young Adult ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Canal ◽  
Femoral Bone ◽  
Severe Osteoporosis ◽  
Type C ◽  
The Mean ◽  
Hip Arthroplasties

Abstract Background: Dorr Type C femoral bone exhibits a wide, stovepipe-shaped femoral canal and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation.Methods: A total of 42 hip arthroplasties were performed in 35 young patients (range, 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 ± 3.7 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m2 (range, 16.8–23.2 kg/m2). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index≤3). Results: The mean follow-up period was 5.5 ± 1.1 years (range, 3.0–8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0±0.5 points (range, 1.0–4.0 points), which significantly improved to 7.5±0.7 points (range, 6.0–8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutral to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up.Conclusions: Based on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with Type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.

scholarly journals Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ping Zhen ◽  
Yanfeng Chang ◽  
Heng Yue ◽  
Hui Chen ◽  
Shenghu Zhou ◽  
...  
Keyword(s):  
Young Adult ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Canal ◽  
Femoral Bone ◽  
Severe Osteoporosis ◽  
Type C ◽  
The Mean ◽  
Hip Arthroplasties

Abstract Background Dorr type C femoral bone exhibits a wide, stovepipe-shaped femoral canal, and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation. Methods A total of 42 hip arthroplasties were performed in 35 young patients (range 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m2 (range, 16.8–23.2 kg/m2). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index ≤ 3). Results The mean follow-up period was 5.5 years (range 3.0 to 8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0 ± 0.5 points (range, 1.0–4.0 points), which significantly improved to 7.5 ± 0.7 points (range 6.0 to 8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutrally to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up. Conclusions Based on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.

scholarly journals Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

2020 ◽  
Author(s):  
Ping Zhen ◽  
Yanfeng Chang ◽  
Heng Yue ◽  
Hui Chen ◽  
Shenghu Zhou ◽  
...  
Keyword(s):  
Young Adult ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Canal ◽  
Femoral Bone ◽  
Severe Osteoporosis ◽  
Type C ◽  
The Mean ◽  
Hip Arthroplasties

Abstract BackgroundDorr Type C femoral bone exhibits a wide, stovepipe-shaped femoral canal and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation.MethodsA total of 42 hip arthroplasties were performed in 35 young patients (range 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m 2 (range, 16.8-23.2 kg/m 2 ). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index≤3).ResultsThe mean follow-up period was 5.5 years (range 3.0 to 8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0 ± 0.5 points (range, 1.0-4.0 points), which significantly improved to 7.5 ± 0.7 points (range 6.0 to 8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutrally to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up.ConclusionsBased on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with Type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.

scholarly journals Modular tapered conical revision stem in hip revision surgery: mid- term results

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Loris Perticarini ◽  
Stefano Marco Paolo Rossi ◽  
Alberto Fioruzzi ◽  
Eugenio Jannelli ◽  
Mario Mosconi ◽  
...  
Keyword(s):  
Preoperative Assessment ◽  
Bone Defects ◽  
Implant Design ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Stem Design ◽  
Additional Surgery ◽  
Prime Concern ◽  
Distal Fixation

Abstract Background The aim of this paper is to evaluate the clinical and radiological outcomes of a fluted tapered modular distal-fixation stem at medium to long-term follow-up. The hypothesis of this investigation was to verify if the use of this implant design may have provided potential advantages in femoral revisions and post-traumatic instances where the restoration of the anatomy was the prime concern. Methods We retrospectively reviewed 62 cases of femoral revision surgeries, performed in Paprosky type IIIA and IIIB bone defects between January 2001 and December 2011 with a mean follow-up of 8.5 ± 1.5 years (range 5.1–15.9 years) where a modular fluted stem was used. The clinical assessment was performed with the Harris Hip Score (HHS), and the radiographic evaluation was carried in order to assess the stability of the femoral component. Intra-operative and postoperative complications were recorded, and the rates of complications and revisions for any cause were determined. Results Mean HHS improved 35.4 points from the preoperative assessment. Radiographic evaluation showed a stable stem anchorage in 90.3% of the cases at the last follow-up. Five (8%) implants required additional surgery. Neither breakage of the stem nor loosening of the taper junction were recorded. Kaplan-Meier survivorship was 89.4% (CI: 88.8–90%) for any complication and 92.3% (CI: 91.8–92.7%) according to revision for any causes at 81 months follow-up. Conclusions Our findings suggest that this stem design is a reliable option in cases of complex femoral bone defects, as well as in cases with high functional deficiencies, with promising survivorship.

scholarly journals Ten-year comparison of two different techniques for femoral bone cavity preparation—broaching versus compaction in patients with cementless total hip arthroplasty

2021 ◽  
Vol 2 (12) ◽  
pp. 1035-1042
Author(s):  
Maciej Okowinski ◽  
Mette Holm Hjorth ◽  
Sebastian Breddam Mosegaard ◽  
Jonathan Hugo Jürgens-Lahnstein ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Total Hip ◽  
Stem Subsidence ◽  
Femur Fractures

Aims Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for primary total hip arthroplasty (THA) in terms of migration, clinical, and radiological outcomes. Methods A total of 28 patients received one-stage bilateral primary THA with cementless femoral stems (56 hips). They were randomized to compaction on one femur and broaching on the contralateral femur. Overall, 13 patients were lost to the ten-year follow-up leaving 30 hips to be evaluated in terms of stem migration (using radiostereometry), radiological changes, Harris Hip Score, Oxford Hip Score, and complications. Results Over a mean follow-up period of 10.6 years, the mean stem subsidence was similar between groups, with a mean of -1.20 mm (95% confidence interval (CI) -2.28 to -0.12) in the broaching group and a mean of -0.73 mm (95% CI -1.65 to 0.20) in the compaction group (p = 0.07). The long-term migration patterns of all stems were similar. The clinical and radiological outcomes were similar between groups. There were two intraoperative fractures in the compaction group that were fixed with cable wire and healed without complications. No stems were revised. Conclusion Similar stem subsidence and radiological and clinical outcomes were identified after the use of compaction and broaching techniques of the femur at long-term follow-up. Only the compaction group had intraoperative periprosthetic femur fractures, but there were no long-term consequences of these. Cite this article: Bone Jt Open 2021;2(12):1035–1042.

scholarly journals The Reconstruction Accuracy of the Hip Center of Rotation After Cementless Total Hip Arthroplasty for Failed Treatment of Acetabular Fractures. Does It Matter?

2021 ◽  
Author(s):  
Liang Zhang ◽  
Mingxue Chen ◽  
Zhuyi Ma ◽  
Tao Bian ◽  
Shaoliang Li ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Acetabular Fractures ◽  
X Rays ◽  
Reconstruction Accuracy ◽  
Center Of Rotation ◽  
Total Hip ◽  
Radiographic Outcomes ◽  
Negative Effect ◽  
Hip Arthroplasties

Abstract Background To assess the impaction of reconstruction accuracy of hip center of rotation (COR) on midterm clinical and radiographic results of cementless reconstruction of total hip arthroplasties (THAs) for patients after failed treatment of acetabular fractures. Methods One hundred and four patients (107 hips) who underwent THAs after failed treatment of acetabular fractures were retrospectively evaluated and cementless cups and stems were implanted in all hips. Clinical outcomes were assessed using the Harris hip score (HHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scoring system. Radiographic results were analyzed by serial perioperative x-rays. Results At the latest follow-up examination, the median HHS increased from 52 (42-65) before surgery to 93 (90-97) (p < 0.001) and the median WOMAC decreased from 52 (36-65) before surgery to 5.8 (1.5-8) (p < 0.001). Compared with normal contralateral hip, 79 cups migrated superiorly (0.2-33.6mm) and 22 cups migrated inferiorly (0.2-16.1mm). The distance of superior migration of reconstructed COR was correlated with positive Trendelenburg sign at the latest follow-up examination (r=0.504; p < 0.001). The percentage of postoperative Trendelenburg sign was significantly higher in superior migration subgroup than that in subgroup with anatomical restoration of COR (P=0.015). Conclusions Cementless THAs in patients after failed treatment for acetabular fractures achieved predictable clinical and radiographic outcomes. A superiorly migrated hip COR appeared to exert a negative effect on abductor muscle function.

Mid- to long-term outcomes of cementless modular, fluted, tapered stem for massive femoral bone loss in revision total hip arthroplasty

2020 ◽  
Author(s):  
Kai Zheng ◽  
Ning Li ◽  
Weicheng Zhang ◽  
Jun Zhou ◽  
Yaozeng Xu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Long Term Results ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Total Hip ◽  
Tapered Stem

Abstract Background: Revision total hip arthroplasty is frequently accompanied by bone loss. The purpose of this study is to evaluate mid- to long-term results of revision total hip arthroplasty for massive femoral bone loss using cementless modular, fluted, tapered stems.Methods: During the period of 2007 to 2015 at a single hospital, 34 hips (33 patients) underwent primary revision surgery with cementless modular, fluted, tapered stems due to massive bone loss, and patients with prosthetic joint infection (PJI) or tumours were excluded. The hips were revised with the LINK MP (Waldemar Link, Hamburg, Germany) prosthesis. Bone loss was categorized by the Paprosky classification for prosthesis loosening and Vancouver classification for peri-prosthetic fracture. All revision bearing surfaces were ceramic-on-ceramic (CoC). Clinical outcomes, radiographic outcomes and survivorship were evaluated.Results: The mean follow-up was 9.1±2.5 years (range, 5-13 years). The Harris hip score was 43.6±11.5 preoperatively and maintained at 86.5±6.6 at the time of latest follow-up (p<0. 05). The X-ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in 3 hips (9%) and instability in 1 hip (3%). The average stem subsidence was 3.9±2.2 mm (range, 1 to 10 mm). The survivorship of prostheses with re-revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10-year follow-up. Three (9%) re-revisions were needed, including 1 for aseptic loosening, 1 for dislocation and 1 for infection.Conclusions: The mid- to long-term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stem (LINK MP stem) are encouraging for massive femoral bone loss.

Periacetabular Bone Densitometry after Total Hip Arthroplasty with Highly Porous Titanium Cups: A 2-Year Follow-Up Prospective Study

2017 ◽  
Vol 27 (6) ◽  
pp. 551-557 ◽  
Author(s):  
Leo Massari ◽  
Alessandro Bistolfi ◽  
Pier Paolo Grillo ◽  
Alda Borré ◽  
Gaetano Gigliofiorito ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Mineral Density ◽  
Cellular Solid ◽  
Total Hip ◽  
Sf 36

Introduction Trabecular Titanium is an advanced cellular solid structure, composed of regular multiplanar hexagonal interconnected cells that mimic the morphology of the trabecular bone. This biomaterial demonstrated improved mechanical properties and enhanced osteoinduction and osteoconduction in several in vitro and in vivo studies. The aim of this study was to assess Trabecular Titanium osseointegration by measuring periacetabular changes in bone mineral density (BMD) with dual-emission X-ray absorptiometry (DEXA). Methods 89 patients (91 hips) underwent primary total hip arthroplasty (THA) with acetabular Trabecular Titanium cups. Clinical (Harris Hip Score (HHS), SF-36) and radiographic assessment were performed preoperatively, and postoperatively at 7 days and at 3, 6, 12 and 24 months. DEXA analysis was performed only postoperatively, using the BMD values measured at 7 days as baselines. Results After an initial decrease from baseline to 6 months, BMD increased and progressively stabilised in all 3 regions of interest (ROIs). Median (IQR) HHS and SF-36 increased from 48 (39-62) and 49 (37-62) preoperatively to 99 (96-100) and 86 (79-92) at 24 months, indicating a considerable improvement in terms of pain relief, functional recovery and quality of life. BMD patterns and radiographic evaluation showed evident signs of periacetabular bone remodelling and osseointegration; all cups were stable at the final follow-up without radiolucent lines, loosening or osteolysis. No revisions were performed. Conclusions After an initial reduction in periacetabular BMD, all 3 ROIs exhibited stabilisation or slight recovery. Although clinical outcomes and functional recovery proved satisfactory, longer follow-ups are necessary to assess this cup long-term survivorship.

scholarly journals Catastrophic Failure and Metallosis of the Acetabular Component in Total Hip Arthroplasty

2021 ◽  
Author(s):  
FIRAT OZAN ◽  
Murat Kahraman ◽  
Ali Baktır ◽  
Kürşat Gençer
Keyword(s):  
Revision Arthroplasty ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Catastrophic Failure ◽  
Total Hip ◽  
Catastrophic Failures ◽  
Revision Tha ◽  
The Mean ◽  
Hip Arthroplasties

Abstract Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis. Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification. Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised. Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.

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