The Harris-Galante porous acetabular component press-fit without screw fixation. Five-year radiographic analysis of primary cases.
One hundred twenty-two primary total hip arthroplasties were followed for an average of 56 months (range, 48-66 months) in which the Harris-Galante (Zimmer, Warsaw, IN) porous ingrowth acetabular component had been press-fit into the innominate bone without screw fixation. There were no acetabular fractures. No socket was revised for loosening and none were radiographically loose. There was no evidence of disruption of the titanium porous mesh. There was no acetabular osteolysis. Compared to the authors' series of primary hip reconstructions using this same prosthesis inserted with line-to-line reaming and screw fixation, the data indicate that the tight peripheral fit associated with the press-fit technique is effective in reducing both the incidence and extent of bone-implant radiolucencies. However, the increased incidence of radiolucencies near the apex of the acetabulum also suggest that initial contact of the porous surface with live acetabular bone at this location is desirable in order to obtain and maintain an optimal bone-implant interface. Additional studies are necessary to further establish the relationship between the initial fit and long-term fixation of cementless acetabular components. Based on the data and other considerations for eliminating both vascular risk and the potential for fretting wear between the screws and shell, the authors recommend press-fitting without screw fixation for this acetabular component in primary cases when anatomy and bone stock permit. Full seating of the component is recommended in order to obtain dome contact.
Schmalzried
T P
TP
Harbor-UCLA Medical Center.
Wessinger
S J
SJ
Hill
G E
GE
Harris
W H
WH
D000077:Acetabulum; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D016896:Treatment Outcome