Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study.

We reviewed the results in a consecutive series of forty-three unselected hips (forty-one patients) after revision of the femoral component, because of aseptic loosening, with use of so-called second-generation cementing techniques. This series was previously reported on after average follow-up intervals of six and 11.7 years; we now report the results after an average duration of follow-up of 15.1 years (range, 14.2 to 17.5 years). None of the eight patients (eight hips) who had died before this review had had a reoperation. Over the course of the study period, repeat revision was done after four (11 per cent) of the thirty-six index procedures that were the first femoral revision and after three of the seven that were a second or third revision. Of the thirty-five hips in the thirty-three surviving patients, seven (20 per cent) had a repeat revision of the femoral component because of aseptic loosening. The average age at the time of the index revision for this group of patients was fifty-one years. This young age has been associated with distinctly poorer results after revision. In two additional hips (two patients), there was radiographic evidence of loosening of the femoral component. Therefore, the rate of loosening of the femoral component was 26 per cent (nine of thirty-five hips) at an average of 15.1 years. These results support the concept that so-called second-generation cementing techniques have decreased the prevalence of aseptic loosening after femoral revision, compared with the shorter-term results that have been reported after revision with use of so-called first-generation cementing techniques.