OBJECTIVETo investigate the surgical indications and surgical techniques of revision total hip arthroplasty for the failed hemiarthroplasty.

METHODSFrom June 1997 to June 2000, 56 cases (31 males and 25 females) of failed hemiarthroplasty received the revision total hip arthroplasty. The age was from 64 - 75 years (mean 68 years). Among them, there were 29 cases with acetabular erosion, 14 cases with acetabular erosion and central dislocation of femoral head, 12 cases with stem loosening and 1 case with stem fracture. All the cases were revised in one stage, and bone grafts were adopted when necessary.

RESULTSForty-nine cases were followed up for 5 - 8 years (mean, 7 years), and 7 cases had lost. The mean Harris score increased from 37 (rang, 28 - 40) preoperatively to 88 (rang, 84 - 90) at last follow-up. No wound infection and neurovascular injury happened. Only 5 perioperative complications occurred, including 3 deep venous thrombosis, 1 dislocation and 1 cortical fracture. No cups or femoral stems needed re-revision. Radiographic analysis showed that the position of the artificial prosthesis was unchanged, and no loosening sign existed.

CONCLUSIONSThe acetabular erosion and central dislocation of femoral head are the main reasons for revision total hip arthroplasty after hemiarthroplasty. The medium-term follow-up results show that the clinical effects are encouraging if the surgical indications and surgical techniques are suitable.