A series of 1321 total hip arthroplasties including 238 primary revisions (18%) were evaluated to identify intrinsic factors of the femoral canal that might influence the success of a cemented total hip replacement. A survival analysis was used to compare the success rates of cemented femoral components. These were classified into five groups according to the condition of the medullary canal at the time of surgery: primary surgery, aseptic cemented loosening, failed noncemented hemiarthroplasty, previous septic failure, or fractured femoral prosthesis with rigid distally fixed cement. The overall survival rates of the five groups were found to be significantly different (p < 0.01). Specifically, the success rates of recemented revisions for aseptic loosening were significantly lower than those for primary total hip replacements (p < 0.01). No statistical difference was found between the success rates of primary surgeries and the revision success rates for septic failure or for a fractured femoral component.
Center for Hip and Knee Surgery, Mooresville, Indiana, and Louisiana State University, Shreveport, Louisiana.
Reprint requests to Merrill A. Ritter, M.D., Center for Hip and Knee Surgery, 1199 Hadley Rd., Mooresville, IN 46158.
Received: December 1, 1987.