Extensively porous-coated femoral revision for severe femoral bone loss: minimum 10-year follow-up.

Of 275 femoral revisions done at our institution from 1982 to 1986, we identified 34 patients (35 hips) who represented the senior author's (C.A.E., Sr.) most difficult revision cases as a result of extensive femoral bone loss at least 10 cm below the lesser trochanter. The patients were revised with fully porous-coated femoral components >or=190 mm. We evaluated 25 of the patients (26 hips) who had a minimum 10-year follow-up (mean, 13.3 years). Survivorship was 89% at 10 years with femoral revision as the endpoint (Kaplan-Meier). The femoral aseptic loosening rate was 15% (4 of 26). Three stems were loose but did not warrant reoperation. One stem was revised for aseptic loosening, 1 was revised for septic loosening, and 1 was revised for a fractured femoral component. Bypassing weak or absent femoral bone with an extensively porous-coated stem is an effective reconstructive technique for patients with extensive femoral bone loss.