Acetabular osteolysis with cementless cups: a 5 to 7 year follow-up.
We reviewed the results of 172 plasma-sprayed, titanium primary total hip arthroplasties inserted without cement and followed 5 to 7 years. Hips were replaced for a wide range of diagnoses and patient ages. No femoral components had been revised nor were considered unstable. Clinical results have been excellent; 88% of hips had either no or a slight amount of pain and only 5% of patients had thigh pain when specifically asked. Radiographically, this femoral component achieved stability after an initial subsidence in 9% of cases. Extensive femoral bone resorption was rare, and distal cortical hypertrophy was commonly seen. Pelvic osteolysis occurred in 16 (9%) cases and was considered major in 10 of these. It was the cause of failure of 3 acetabular components. Femoral endosteal lysis was not observed. We concluded that mechanical stability of the Mallory-Head titanium total hip prostheses is excellent. However, significant pelvic osteolysis has occurred commonly with this implant design, and will continue to pose major reconstructive problems in the future.
Rorabeck
C H
CH
University of Western Ontario, London, Canada.
Bourne
R B
RB
Mulliken
B D
BD
Nayak
N
N
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D002484:Cementation; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D006984:Hypertrophy; D007592:Joint Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology*; D010146:Pain / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013314:Stress, Mechanical; D014025:Titanium; D016138:Walking / Q000502:physiology
D014025:Titanium