Objective To explore the outcomes of cemented prostheses and cementless modular Prostheses in revision total hip arthroplasty.Methods We designed a retrospective cross-sectional study to compare outcomes of the two femoral implant designs. Between March 2005 and June 2010, 23patients underwent revision with the cementless modular stem and 22 patients with the cemented stem at our institution. Patients in the study were all paprosky type I or type II. The recorded and compared preoperative characteristics of the two patient cohorts included HHS, VAPS, mild thigh pain, complications rate and radiographs obtained preoperatively. ResultsAt the last follow-up, the mean postoperative HHS was 79.2 (range, 32-100) in the cemented stem group and 83.9 (range, 61-100) in the cementless modular stem group. The postoperative VAPS scores averaged 0.7 (range, 0-4) in the cemented group and 0.5 (range, 0-3) in the cementless group. Mild thigh pain occurred in 1 (4%) patients in the cemented group and 1 (9%) patient in the cementless group. Complications occurred in4(19%) patients in the cemented group and 5(22%) patient in the cementless group. the median stem subsidence occurred in3(14%) patients in the cemented group and 2(9%) patient in the cementless group. There was no significant statistics difference between two groups of evaluation index.Conclusion In revision total hip arthroplasty, cemented femoral prosthesis and uncemented prosthesis implants are suitable for femoral defect PaproskyⅠ,Ⅱ type. Standardizing the use of cement technology and matching prosthetic choice is an important factor in the success of surgery.%目的：骨水泥和非骨水泥股骨假体在髋关节翻修术中临床应用。方法回顾2005年3月至2010年6月，23例以非骨水泥假体行人工髋关节翻修术患者,22例以骨水泥假体行人工髋关节翻修术患者。只纳入了股骨骨缺损PaproskyⅠ、Ⅱ型。临床结果评估Harris髋关节评分(HHS)和VAPS评分和大腿疼痛的发生率。同时评估并发症的发生率。影像学评估再次股骨柄下沉以及股骨柄稳定性。结果骨水泥组术后HSS的平均值为79.2(范围32~100),非骨水泥组术后HSS的平均值为83.9(范围61~100)。骨水泥组术后VAPS评分平均为0.7(范围0~4)、非骨水泥组术后VAPS平均值0.5(范围0~3)。术后大腿疼痛骨水泥组发生1例(4%),非骨水泥组发生1例(9%)。并发症骨水泥组发生4例(19%),非骨水泥组发生5例(22%)。假体再次下沉松动骨水泥组发生3例(14%),非骨水泥组发生2例(9%)。两组评估指标差异无统计学意义。结论在髋关节翻修术中,骨水泥股骨假体和非骨水泥股骨假体均适用于股骨骨缺损PaproskyⅠ、Ⅱ型。规范的骨水泥使用技术和匹配的假体选择是手术成功的重要因素。
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