Outcomes of revision total hip arthroplasty using a vascularised anterior femoral window

Abstract

Purpose: Extraction of the distal femoral cement mantle and restrictor during revision total hip arthroplasty (rTHA) is challenging and can compromise host bone stock. The aim of this study is to report outcomes of our femoral windowing technique for cement removal.

Methods: We report on a cohort of 36 patients with an average age of 68.7 years who underwent 40 cemented rTHA between 2011 and 2017 using a vascularised anterior femoral window. Clinical and radiological outcomes were retrospectively reviewed with a mean follow-up of 6.6 years (range, 3.8-10).

Results: Latest mean WOMAC score was 25.4 and all windows achieved radiographic union by a mean of 7.9 weeks. Femoral component survivorship was 100% and 38 out of 40 rTHAs showed no evidence of radiological loosening.

Conclusion: The vascularised anterior window to remove the distal femoral cement mantle under direct vision is safe and reproducible with excellent clinical and radiographic results.