The aim of this study is the presentation of the results in 48 cases of revision THA with excessive proximal bone loss with the use of the Wagner cementless femoral stem The bone loss classified with the AAOS system for proximal femoral bone deficiency in type I (17 patients), II (27 patients), and III (4 patients). We used the titanium alloy Wagner stem trying to achieve primary distal stabilisation because of its conical shape and its longitudinal ridges while we expected secondary proximal stabilization due to the osseointegration properties of the material. We didn’t use grafts. The mean follow- up is 9, 6 years. The results are very satisfactory to excellent with marked pain relief, improvement of the walking ability and excessive bone restoration in the proximal part of the femur. 7 of the patients had a symptomless stem subsidence up to 16mm the first year with subsequent stabilization thereafter. One of the patients required a new revision the 7th postoperative year due to stem’s fracture in its distal part. We conclude that the Wagner stem in these difficult THA revisions offers firm primary distal fixation, impressive proximal bone regeneration and satisfactory clinical outcomes without using grafts.
