Removal and reinsertion of cemented femoral components during acetabular revision.

A retrospective review examined all patients who underwent removal and reinsertion of a cemented femoral component during isolated acetabular revision by one surgeon since 1981. All components were reinserted into the original, intact cement mantle. Forty-two hips with 2- to 10-year follow-up periods were reviewed. Average follow-up period since revision was 67 months. Average followup period since index procedure was 191 months. Average Harris hip score increased from 61 before surgery to 90 at follow-up examination. Two femurs are definitely loose by Harris criteria, but both are asymptomatic. One solidly fixed femoral component was revised because of joint instability. Two hips have postrevision cement fractures. One patient has mild thigh pain. In vitro testing of eight cadaver hips showed no increase in rotational micromotion following removal and reinsertion. It is concluded that this technique aids in isolated acetabular revision surgery by avoiding the complications of trochanteric osteotomy and femoral revision, improving acetabular exposure, and decreasing operative time with minimal risk of disrupting femoral component fixation.