To evaluate the efficacy of Wagner self-locking stem (Wagner SL) in femoral revision.

Sixty-one hip revision cases using Wagner SL revision stems in Renmin Hospital of Wuhan University were retrospectively analyzed. These cases included 36 males, 25 females; mean age of (61±7) years. The visual analogue scale (VAS) and Harris hip score system was used to evaluate the clinical efficacy. The position of the acetabulum and femoral prostheses and the changes of bone around them were observed according to the pelvic plain film and the positive and lateral X-ray of the hip. The visual analogue scale(VAS)and Harris hip score were adopted for evaluation and analyzed by paired t test.

All the patients were followed up for (5.6±2.2) years. During the follow-up, no infection around the prosthesis and loosening of the prosthesis occurred. One patient had dislocation two weeks after the surgery and did not relapse after manual reduction. One patient had a periprosthetic fracture two years after the operation and was treated with open reduction and internal fixation. Compared to the preoperative score, the VAS(one month after surgery t=10.5505, P<0.01; three months after surgery t=12.6154, P <0.05; six months after surgery t=16.6196, P <0.05)and Harris scores(one month after surgery t=14.1128, P <0.05; three months after surgery t=30.0689, P <0.05; six months after surgery t=59.9639, P <0.05) were greatly improved at the three follow-up time points, and the differences were significant. At the last follow-up, the Harris scores were excellent in 45 cases; good in 10 cases; fair in six cases; the excellent and good rate was 90.2%. At the last follow-up, there was no significant change in the position of the femoral stem prosthesis. Bone remodeling around the stem of the proximal femur could be seen in all the cases, among which 56 cases were degree Ⅰ, five cases were degree II .

For the patients with femoral periprosthetic fractures (Vancouver B2, Vancouver B3) and proximal femoral bone defects (Parprosky II, Parprosky Ⅲ), the Wagner SL revision stem is a good choice, which is easy to use and has been proved to be reliable in enabling restoration of the bone stock, and the clinical effcacy is satisfactory.