Removal of cementless stems.

Cementless femoral components may require removal because of loosening, thigh pain, infection, or hip instability. Methods to efficiently remove cementless implants of different designs and minimize bone loss have improved. Loose stems usually can be removed safely by clearing bone in the greater trochanteric region before removal. Well-fixed stems can be removed using cutting instruments to divide areas of bone ingrowth or ongrowth. When bone ingrowth involves the diaphyseal area, extended greater trochanteric osteotomies are especially effective in facilitating implant removal.