Hip prosthesis révision using uncemented press-fit stem

Hip stem replacement using uncemented press-fit stem are based on Wagner's concept (1987). The stem used is a straight, conical, titanium rod, whose objective is twofold: osteo-integration and bone regeneration. Planning must be rigorous, based, among other things, on a large-format femoral, face and profile X-ray assessment. Technically, to obtain a diaphyseal press-fit, it is preferable to perform a trans femoral approach, supplemented by a medial cortical osteotomy to be able to implant a right pivot in a femur whose curvatures are accentuated. The proximal femoral reconstruction around the implant in place must be the subject of special attention, as this will condition the final result. Our initial series [154 patients, 5 years of average follow-up (1-10 years)] found a survival rate of 94% at 10 years. Osteopenia and the absence of a residual isthmic zone represent the essential limits of this concept.