Uncemented or cemented revision stems? Analysis of 2,296 first-time hip revision arthroplasties performed due to aseptic loosening, reported to the Swedish Hip Arthroplasty Register

Figures & data

Figure 1. Flow chart of excluded stems.

Table 2. Demographic data of patients operated with uncemented or cemented revision stems. Values are frequency (%) unless ­otherwise specified

	Uncemented	Cemented
Factor	n = 1,668	n = 1,328
Women	713 (43)	580 (44)
Mean age at index surgery (SD)	72 (10)	74 (9)
Mean follow-up time, years (SD)	5.5 (4.0)	7.5 (4.5)
Mean time between primary and revision surgery, years (SD)	12.3 (6.0)	12.4 (5.7)
Diagnosis at primary THA
Osteoarthritis	1,321 (79)	1,057 (80)
Fracture	90 (5.4)	86 (6.5)
Inflammatory disease	115 (6.9)	95 (7.2)
Condition after childhood disease	70 (4.2)	39 (2.9)
Other	72 (4.3)	51 (3.8)
Approach at index surgery
Direct lateral	831 (50)	554 (42)
Posterior	837 (50)	774 (58)
Approach at primary THA
Direct lateral	858 (51)	506 (38)
Posterior	810 (49)	822 (62)
Concomitant cup revision	1,258 (75)	1,328 (74)
Head size, mm
22	90 (5.4)	112 (8.4)
28	841 (50)	870 (66)
32	570 (34)	271 (20)
36	167 (10)	75 (5.6)

Concomitant cup revision does not include only liner change.

Figure 2. Unadjusted survival of uncemented and cemented revision stems.

Table 6. Risk of re-revision for uncemented revision stems, stratified by age groups at index revision surgery, with cemented stems as reference

	Year after index revision surgery
	1st	Between 2nd and 13th
Patient age	HR (CI)	HR (CI)
< 68	1.0 (0.7–1.4)	1.0 (0.7–1.6)
68–73	1.0 (0.7–1.8)	0.6 (0.3–1.3)
74–79	1.4 (0.9–2.2)	1.5 (0.8–3.0)
> 79	2.4 (1.3–4.4)	0.9 (0.3–2.5)

HR (CI): adjusted hazard ratio and 95% confidence interval.

Table 7. Reasons for re-revision for uncemented and cemented revision stems. Values are frequency (%)

Reasons for re-revision	Uncemented	Cemented
Aseptic loosening	49 (25)	65 (52)
Deep infection	38 (20)	18 (14)
Dislocation	65 (34)	17 (14)
Fracture	12 (6)	13 (10)
Other	29 (15)	13 (10)