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.