Results of revision total hip arthroplasty with Anatomic BR stem: 10-year minimum follow-up

Twenty cementless total hip revision arthroplasties using Anatomic BR stems were performed in 20 patients. Fourteen patients, with a mean age of 62.6 years (range 41–74 years) at time of revision surgery, were followed retrospectively for a minimum of 10 years (range 11–15 years). Clinical function and radiographic evidence of implant stability were evaluated. Preoperative femoral deficiencies were evaluated radiographically and classified according to Paprosky type as follows: four Type-II, four Type-IIIA, four Type-IIIB, and two Type-IV femurs. Mean preoperative Harris hip score was 46.3 points (range 29–58 points) and improved to 68.8 points (range 45–90 points) at the most recent follow-up examination. Of the 14 patients followed, six had radiographic evidence of subsidence (axial shift of more than 2 mm after revision with long-stem components). Component fixation showed bone ingrowth in three (21%) patients, inconclusive evidence of ingrowth in six (43%) patients, suboptimal but stable fixation in three (21%) patients, and unstable fixation in two (14%) patients. Based on these we results, we conclude that even with circumferential proximal porous coating and improved proximal geometry, nonmodular femoral implant stability remains unpredictable following total hip arthroplasty revision.