J Orthopaed Traumatol (2008) 9:57–62 DOI 10.1007/s10195-008-0009-3 O R I G I N A L A R T I C L E Revision total hip arthroplasty using the Zweymuller femoral stem Matthew E. Oetgen Æ Michael H. Huo Æ Kristaps J. Keggi Received: 11 January 2008 / Accepted: 6 March 2008 / Published online: 10 May 2008 Springer-Verlag 2008 Abstract Background A variety of femoral stem designs have been reported to be successful in revision total hip arthroplasty without consensus as to optimal design. We evaluated the clinical and radiographic outcomes in a consecutive series of femoral revisions using a wedge-shape, tapered-stem design at medium and long-term follow-up. Materials and methods We performed a retrospective review of clinical and radiographic outcomes of twenty- eight consecutive femoral revisions arthroplasties, which were done using the Zweymuller femoral stem. Results The mean follow-up was 7.4 years (range 2–15 years). No stem re-revision was necessary. All stems were judged to be stable by radiographic criteria at the most recent follow-up. The ﬁnal mean Harris hip score was 90. There was no difference in Harris hip scores, implant sta- bility, or radiological appearance (distal cortical The authors have no ﬁnancial relationship with any product mentioned in this manuscript. We have full control of all primary data and agree to allow the journal to review the data if requested. M. E. Oetgen (&) K. J. Keggi Department of Orthopedics and Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520, USA e-mail: matthew.oetgen@yale.edu K. J. Keggi Keggi Orthopedic Foundation, Turnpike Ofﬁce Park, 1579 Straits Turnpike, Middlebury, CT 06762, USA M. H. Huo Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, TX 75390-8883, USA hypertrophy or proximal stress shielding) of the implants between medium-term (mean 5.7 years) and long-term (mean 12.4 years) follow-up. Conclusions We found the Zweymuller femoral stem design to be durable for revision hip arthroplasty when there is an intact metaphyseal-diaphyseal junction for adequate press-ﬁt stability at surgery. Keywords Total hip arthroplasty Femoral component Revision Introduction Total hip arthroplasty (THA) is one of the most successful orthopedic reconstructive operations. Improvements in design, biomaterial, and surgical techniques have led to increased durability of THAs. Despite these improvements and innovations, failures do occur and revision surgeries are necessary. Revision rates for aseptic failure have been reported between 1.5% and nearly 20% in mid- to long- term follow-up [1]. Many stem designs and surgical tech- niques have been utilized in revision of the femoral stem. These include: cement ﬁxation [2], cementless proximally- coated stems [3], extensively-coated stems [4], and mod- ular stems [5, 6]. Regardless of the stem design, the principle pre-requisites for femoral revision are: maxi- mizing ﬁt, immediate press-ﬁt stability, control of axial and rotational stability, and optimal bone-remodeling in the long-term. Variable success rates have been reported with each design and technique. The purpose of this study was to evaluate the clinical and radiographic outcome in a consecutive series of fem- oral revisions done by a single senior surgeon using a unique stem design at mid-term follow-up. 123