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Femoral Component Revision with Use of Impaction Bone-Grafting and a Cemented Polished StemA Concise Follow-up, at Fifteen to Twenty Years, of a Previous Report*
Martijn A.J. te Stroet, MD1; Jean W.M. Gardeniers, MD, PhD1; Nico Verdonschot, PhD1; Wim H.C. Rijnen, MD, PhD1; Tom J.J.H. Slooff, MD, PhD1; B. Willem Schreurs, MD, PhD1
1 Department of Orthopaedics 357, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500HB Nijmegen, The Netherlands. E-mail address for M.A.J. te Stroet: m.testroet@orthop.umcn.nl. E-mail address for B.W. Schreurs: b.schreurs@orthop.umcn.nl. E-mail address for N. Verdonschot: n.verdonschot@orthop.umcn.nl. E-mail address for W.H.C. Rijnen: w.rijnen@orthop.umcn.nl. E-mail address for T.J.J.H. Slooff: tslooff@gmail.com. E-mail address for J.W.M. Gardeniers: j.gardeniers@orthop.umcn.nl
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Investigation performed at the Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

Original Publication Schreurs BW, Arts JJ, Verdonschot N, Buma P, Slooff TJ, Gardeniers JW. Femoral component revision with use of impaction bone-grafting and a cemented polished stem. J Bone Joint Surg Am. 2005 Nov;87(11):2499-507.

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Dec 05;94(23):e173 1-4. doi: 10.2106/JBJS.K.01432
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We previously reported our results for thirty-three consecutive femoral component revisions with impaction bone-grafting, performed with the X-change femoral revision system and a cemented polished Exeter stem, at a minimum of eight years of follow-up. The present updated study shows the results after fifteen to twenty years. One stem was revised again for mechanical reasons during a rerevision of an acetabular cup. The probability of survival at seventeen years was 96% (95% confidence interval [CI], 72% to 99%) with a femoral rerevision for any reason as the end point and 100% (95% one-sided CI, 69% to 100%) with rerevision for aseptic loosening as the end point. The average subsidence was 3 mm and stable relative to our previous report. Although three early femoral fractures occurred after this surgery, in this update no additional fractures were seen. In conclusion, the probability of survival of femoral component revisions with impaction bone-grafting and a cemented polished stem was excellent at a mean of seventeen years.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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