Use of Wagner cementless self-locking stems for massive bone loss in hip arthroplasty.

OBJECTIVE: To assess the use of Wagner cementless self-locking stems for massive bone loss in hip arthroplasty. METHODS: 22 patients with severe proximal femoral bone loss either due to prosthetic loosening or comminuted fracture were treated by Wagner cementless self-locking revision stems between November 1993 and June 1995. RESULTS: Radiographic evidence of early bony incorporation was found by 1 month in most cases. At a mean follow-up of 7.1 years, the mean Harris hip score increased from 30 to 84 points. It was less than 80 points in 4 patients, 2 of whom experienced severe thigh pain due to marked progressive subsidence of the stems (by 13 mm and 20 mm), which were revised 2 and 3 years later respectively. CONCLUSION: Implantation of a Wagner cementless self-locking revision stem provided satisfactory results for 82% of patients. Hence, in some difficult conditions, this device is a good choice of management.