Seventy-four revisions of the femoral component featuring placement of a Wagner stem in 74 patients operated upon between 1995 and 2003 were reviewed. Clinical evaluation, radiological assessment, and survival analysis of revision stems were conducted. The mean follow-up duration was 14.4 years (range, 11 to 19 years). When failure was defined as stem removal for any reason, 4 of 64 stems had to be further revised during the follow-up period, yielding a cumulative stem survival rate of 93.8% (95% CI: 87.7% to 98.2%) at 18 years. The Wagner revision stem is an effective implant for revision hip surgery when bone stock is lacking. Use of the stem affords mechanical stability even when bone loss is massive. (C) 2015 Elsevier Inc. All rights reserved.