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There were a total of 231 patients with 248 revision procedures performed. There were 127female and 104 male patients and the mean age at the time of revision surgery was 69.4 years.Twenty-two of these patients had had at least one prior revision operation on the index hip.Thirty hips were treated with a cemented Echelon stem and 218 treated with a cementlessEchelon stem. Of the 248 hips 14 patients were lost to follow-up (14 hips) and 9 patients (9hips) are deceased. The average follow-up was 5.9 years.Of the 225 hips remaining in the follow-up series there was a single case of aseptic looseningconfirmed radiologically. Twenty-one hips were diagnosed with infection (9.3%); 6 of thosepatients had had at least one prior revision procedure and 4 additional patients had a priordiagnosis of infection. Therefore, 10 of the 21 hips were either definitely or probably infectedat the time of their revision operation on which we are reporting. Nine patients (4%) hadmultiple dislocations post-operatively. These were patients who had undergone multiplerevisions or whose primary revision operation was for instability. An additional 18 patients(8%) had a single dislocation treated by closed reduction requiring no further treatment.There were 6 hips with intra-operative fracture requiring immediate re-revision plus fracturefixation and a further 12 hips (5.3%) who sustained a peri-prosthetic fracture some time aftertheir revision procedure.Despite the number of complications the majority of patients required no further surgicaltreatment. Eleven hips (4.8%) required re-revision of the femoral component. Therefore theoverall survival rate at 5.9 years of the Echelon revision stem was 95.2%.Discussion:Femoral revision total hip arthroplasty is a difficult operation with uncertain outcome. Allseries recognize a significant complication rate primarily as a consequence of infection,instability or intra-operative or peri-operative fractures secondary to poor bone quality.Our experience with the Echelon revision stem demonstrates excellent incorporation of theimplant with a negligible rate of re-revision for failure of bone ingrowth; the othercomplications are consistent with those reported in other series.Conclusions:Although the complication rate in this group of patients is high only 4.8% of the hips requiredre-revision of the femoral component Of significance was the lack of re-revision necessitatedby aseptic loosening of this revision stemfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]