ABSTRACT

Objectives:

We evaluated the clinical results of the Wagner SL ( Self-Locking) revision stem in femoral revisions.

Material and Methods:

36 patients were revised (20 total hip arthroplasties, I6 hemiarthroplasties) after between I3 and I06 months (average 74 months). It was the first revision in all hips except 3 . The mean age was 64.8 (range 38 to 86) years. Indications for revision was aseptic loosening in 30 hips, periprosthetic femoral fracture in 2 hips, fracture of the femoral implant in 3 hips. In one hip, Wagner revision stem was inserted during a second-stage reimplantation after the performance of a Girdlestone resection arthroplasty to treat chronic infection. 16 acetabular components of20 patients who had previously undergone total hip arthroplasty were changed at the same time of femoral revision. The mean follow up was 50.2 ( range 23 to 7I ) months.

Results:

At the most recent follow-up evaluation the Harris hip scores had improved from a preoperative average of 47 .6 (range 2I to 86) points to an average of91.2 points (range 60 to IOO). The radiographs showed new bone formation in 32 femoral components(% 88). In all patients but one osteolysis have not been observed. Subsidence of the femoral stem have occured in 8 patients (% 22). Although 4 components subsided less then 3 mm, 3 components subsided 5 mm and I component subsided IO mm. 3 patients (% 8) had early postoperative dislocations. I of these was treated by closed reduction. The second had a revision of the cup angle. In the third patient, the cup was reset at another angle and the femoral component was re revised with a larger stem.

Conclusion:

Wagner SL femoral stem provides distal fixation so it is a good choice in revision of patients with proximal bone loss . And also we recommend its use in revision of cemented femoral components when the periprosthetic femoral fractures extend to the distal femur.