title: High wear rates and extensive osteolysis in 3 types of uncemented total hip arthroplasty: a review of the PCA, the Harris Galante and the Profile/Tri-Lock Plus arthroplasties with a minimum of 12 years median follow-up in 96 hips.
abstract: BACKGROUND
  High wear rates and femoral and acetabular osteolysis have been-and still are-the main problems in uncemented total hip replacement. We reviewed 96 consecutive cementless total hip replacements of 4 different designs.
  
  
  METHODS
  21 PCA, 25 Harris Galante Porous/Harris Galante I (stem/cup), 25 Profile pressfit/ Tri-Lock Plus (stem/cup) and 25 Profile HA-coated/Tri-Lock Plus (stem/cup) prostheses were included. The operations were performed in the period 1984-1991. Median follow-up ranged from 12-16 years. Wear and osteolysis were measured.
  
  
  RESULTS
  Mean linear wear rates ranged from 0.17 to 0.21 mm/year in the 4 groups, and there were no statistically significant differences between the groups (p = 0.9, ANOVA). Moderate or extensive osteolysis was found in 46 of the 96 hips included. The association between high and low wear rates (more or less than 0.20 mm/ year) and extent of osteolysis was statistically significant (p < 0.001, t-test). We found poor 12-year survival of the primary prostheses in all 4 groups (50-70%), mainly due to revisions because of wear of the polyethylene liner and/or osteolysis. The infrequently documented Profile/Tri-Lock Plus systems did not perform differently from the PCA and the HG.
  
  
  CONCLUSIONS
  The poor long-term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner failure, which are both generally asymptomatic until catastrophic failure appears.
authors.affiliation: Department of Orthopaedic Surgery, Haukeland University Hospital. Bergen. Norway. geir.hallan@helse-bergen.no
authors.forename: Geir
authors.initials: G
authors.lastname: Hallan
authors.forename: Stein A
authors.initials: SA
authors.lastname: Lie
authors.forename: Leif I
authors.initials: LI
authors.lastname: Havelin
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D020099:Coated Materials, Biocompatible; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible