Poor outcome of the PCA and Harris-Galante hip prostheses. Randomized study of 171 arthroplasties with 9-year follow-up.
155 patients (171 hips) with a mean age of 50 years (24-64) were randomized to uncemented PCA (84 hips) or Harris-Galante type I (87 hips) total hip arthroplasty. Clinical and radiographic evaluations were done regularly. The improvements in the Harris hip and pain scores did not differ. Osteolysis developed in 5 PCA and 17 Harris-Galante hips. 13 hips in the PCA and 16 in the Harris-Galante (HG) group were revised because of mechanical failures and 1 hip (HG) because of infection after a mean follow-up of 9 years. Decreased 10-year survival rate, based on revision as end-point, was noted for the PCA (85%), compared with the Harris-Galante cup (99%). The corresponding survival rate of the PCA stem (96%) was higher than that observed for the Harris-Galante design (86%). When radiographic failures were included, the survival rates of the 4 different components dropped to between 73% and 94%. These findings indicate that further revisions will be necessary and continuous radiographic follow-up is indicated to enable revision before severe bone destruction has occurred. Although the PCA and the Harris-Galante designs differed as regards the survival of the individual components, the overall clinical and radiographic survival rates of these cementless total hip arthroplasties were poor.
Thanner
J
J
Department of Orthopedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Kärrholm
J
J
Malchau
H
H
Herberts
P
P
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010146:Pain / Q000209:etiology; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012720:Severity of Illness Index; D016019:Survival Analysis