Femoral revision for a loose cemented stem


This is a 56 year old male with a history of sickle cell disease. He underwent hybrid total hip replacement (cementless acetabular component, cemented femoral component) in his 30s due to avascular necrosis of the hip. He did well from his initial procedure, however reported increasing amounts of thigh and groin pain over the past two years. X-rays demonstrated a well fixed and properly positioned acetabular component with moderate polyethylene wear, and a loose, subsided cemented femoral stem.

The patient underwent revision THA. The femoral stem was revised through an extended trochanteric osteotomy (ETO) to aid in cement removal. An ultrasonic cement removal device was used to aid in meticulous cement removal. A modular tapered titanium stem was used for the reconstruction, followed by cerclage cables to repair the ETO segment.

The patient has done well from surgery and has returned to normal function.