Fig. 2A–C.

A 65-year-old man had aseptic loosening of the cemented femoral component. (A) His prerevision AP radiograph shows a cement fracture, varus shift, and subsidence of the left femoral component. The bone defect of the left femur is Paprosky Type IV. (B) An AP radiograph of the patient’s left hip taken 6 months after surgery shows a fully porous-coated cementless stem and two strut cortical onlay allografts placed in a satisfactory position. Although there is no radiographic loosening of the femoral component, the patient reported severe pain during weightbearing. This patient had the largest size of Solution System^® stem implanted during revision surgery, but he had persistent pain and underwent rerevision surgery using the largest size Wagner stem. (C) The AP radiograph taken 15 years after rerevision surgery shows the Wagner cementless stem is embedded in a satisfactory position with solid bone ongrowth on the entire femoral stem. A two-cortical strut onlay allograft was incorporated in the host bone. The acetabular component is well fixed in a satisfactory position.