Failure of a proximally porous-coated femoral prosthesis in revision total hip arthroplasty.

A retrospective study was done on a consecutive series of patients who had revision of a femoral hip prosthesis using a titanium-alloy implant with proximal fibermesh pads. Of 28 patients who had revision using a Harris-Galante (Zimmer, Warsaw, IN) femoral prosthesis between 1985 and 1989, 25 of them (25 hip arthroplasties) were followed for an average of 5.5 years (range, 4-8 years); the other 3 had died. There were 12 men and 13 women whose age averaged 55 years. Thirty-two percent of the patients had moderate or severe femoral bone stock deficiency before surgery and 72% had intramedullary femoral bone-grafting. All of the patients had revision of the acetabular component using a cementless Harris-Galante prosthesis. Five (20%) of the 25 patients have undergone repeat femoral revision, 4 for aseptic loosening and 1 for persistent thigh pain. Of the 20 hips that have not been revised, 9 (45%) of the femoral prostheses have subsided 5 mm or more. Femoral endosteal lysis was present in 36% of all the hips. Only 8 (32%) of the 25 patients had radiologic signs of bone ingrowth fixation of the femoral component. The average Harris hip score rose from 46 before surgery for all 25 patients to 82 (range, 55-100) at last follow-up examination for the 20 patients not rerevised. Because of the poor clinical results (36% of patients with a poor Harris hip score [4 patients] or rerevised [5 patients]) and radiologic results (48% subsidence) of femoral reconstruction with this proximally porous-coated femoral prosthesis, its use for revision hip surgery is not recommended.