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Generally speaking, a too cautions or confusing attitude should be avoided and at first, a physiotherapy which is only functional should be preferred.

To evaluate the results of an implant, one must have a good knowledge of the patients, of the method used and of the implants placed during revision surgery; the whole of these data is usually called, in a somewhat mundane way, “the material”.

In the literature, most authors use the Harris (13) or the Merle d’Aubigne and Postel (MAP) score systems (17). These so called “universal scores” allow for a good appreciation of the clinical results, since they both rely on criteria that are easily reproducible and show few errors of appreciation between the different authors (which however is only true for the non-modified scores, which, in our opinion, should exclusively be applied). We rely on these two original methods for our own evaluations.

The preoperative radiological analysis includes those 4 parameters which we have defined in the chapter on preparation of the operation (see second part, chapter 1): Amount of osteoporosis, loss of bone stock or local bone defects, morphotype of the femur and possible obstacles for cement extraction.

The postoperative radiological analysis is a decisive step for the appreciation of results of an implant. It is also the most delicate step since the available preoperative classifications are not well suited for this evaluation; on the other hand, the diversity of the evaluative methods proposed for the radiological analysis as well as the incongruent criteria explain the difficulties encountered, when we tried to make a global appreciation of a result and to compare this to the results of other authors.

There is no operation without any complication (this is particularly true for revision surgery). Every concept has its own limitations which must be known to the surgeon using the implant only for those circumstances for which it has been designed and that good results can be expected here if the basic techniques are applied.

Choosing a concept requires awareness of its inherent needs and selection of the appropriate implant; make a precise planning and preparation of the surgery and finally, adapt the surgical technique to the needs and constraints of the chosen method, these are the principles which have to be respected by any surgeon who wants to revise a loose femoral stem.