THA revision for loosening and severe bone loss


This is a 62 year old female who had bilateral cemented hip replacements done in South America approximately ten years ago. She suffered an early postoperative periprosthetic fracture on the right side. She presented to Dr. Chen with severe bilateral hip pain and had limited walking tolerance. X-rays demonstrated loosening of the acetabular and femoral components bilaterally, with Paprosky 3A acetabular defects and 3B femoral defects with varus remodeling.


Over the course of one year, she underwent staged bilateral total hip revisions. The acetabular defects were reconstructed with trabecular metal augmentation. The femurs were reconstructed using an extended trochanteric osteotomy (ETO) for cement removal, followed by long modular tapered titanium revision stems. An allograft femoral strut was also used on the right due to severe bone loss.