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    "datePublished": "2002-09", 
    "datePublishedReg": "2002-09-01", 
    "description": "ObjectiveSafe removal of a loosened or broken femoral stem together with cement particles and soft tissues. Preparation of the implant bed under direct vision and exact fitting of the new stem. Restoration of pain-free hip motion.IndicationsExchange of loosened or broken femoral stem, its simple extraction being impossible or fraught with complications and time-consuming.ContraindicationsExchange procedures that can be performed without resorting to an anterolateral bony lid.Surgical TechniqueAnterolateral approach over the extent of the femoral stem plus cement plug. Fashioning of an anterolateral bony lid (approximately one third of the shaft circumference). The remaining part of the lateral cortex remains undisturbed. If at all possible, a proximal bony ring should be preserved. Distal part of the lid is shaped like a keel. Removal of stem, cement, granulation tissue, and necrotic bone. Reconstruction of the bed for the new femoral stem. All bony cavities are cleaned with a burr and filled with autogenous or allogenic bone. Insertion of revision stem protruding proximally by 1 cm. Closure of the lid. Stabilization with three cerclage wires. Final stable seating of the stem by gentle hammer blows.ResultsThis approach was used in 49 patients (average age 65 years [26\u201398 years]). Two patients died of unrelated causes, two could not be reached. The remaining 30 women and 15 men were followed up for 8.4 years (1\u201314 years). The average Harris hip score improved from 36 to 84 points. All osteotomies consolidated.", 
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        "name": "Orthopaedics & Traumatology Surgery & Research", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
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    "keywords": [
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      "femoral stem", 
      "average Harris hip score", 
      "Harris hip score", 
      "revision hip arthroplasty", 
      "unrelated causes", 
      "hip score", 
      "necrotic bone", 
      "hip arthroplasty", 
      "direct vision", 
      "lateral cortex", 
      "cerclage wires", 
      "hip motion", 
      "granulation tissue", 
      "allogenic bone", 
      "revision stem", 
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      "new stems", 
      "exact fitting", 
      "keel", 
      "removal of stem", 
      "ring"
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    "name": "Fashioning of an anterolateral femoral bony lid for revision hip arthroplasty", 
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