title: Excellent long-term survival of an uncemented press-fit stem and screw cup in young patients: follow-up of 75 hips for 15-18 years.
abstract: BACKGROUND
  The long-term results of uncemented total hip arthroplasties vary widely due to differences in design, metal alloy, coating, surface structure, and porosity.
  
  
  METHODS
  We retrospectively studied 75 cementless Zweymuller SL stems in combination with Endler titanium-backed threaded cups (Z-E) in 70 patients. 35 patients were women, and the mean age at surgery was 52 (24-68) years. 16 patients died and 1 emigrated, 7 patients (of which 1 later died) subsequently underwent revision, and the remaining 47 patients with 50 original arthroplasties were followed up after a median of 16 (15-18) years.
  
  
  RESULTS
  Revision of 8 hips resulted in an 18-year Kaplan-Meier estimated overall survival rate of 88% (CI: 79-96). 6 of 7 cup revisions were due to liner wear and osteolysis, and 1 was due to aseptic loosening. 2 of 3 stem revisions were due to femoral loosening and 1 was due to fracture of the neck of the stem. The clinical results were good, with a mean Harris hip score of 89 (54-100). Half of 70 hips in 65 patients had ectopic bone formation. All unrevised implants were radiographically stable, with a mean liner wear of 0.07 mm/year.
  
  
  CONCLUSIONS
  These long-term results demonstrate that the combination of a Zweymuller SL stem and an Endler titanium-backed screw cup is a good hip arthroplasty in young and active patients. A prefixed polyethylene liner is a drawback, necessitating exchange of the whole cup in cases with polyethylene wear.
authors.affiliation: Departments of Orthopedics, Oslo, Norway. ole.reigstad@rikshospitalet.no
authors.forename: Ole
authors.initials: O
authors.lastname: Reigstad
authors.forename: Per
authors.initials: P
authors.lastname: Siewers
authors.forename: Magne
authors.initials: M
authors.lastname: Røkkum
authors.forename: Birgitte
authors.initials: B
authors.lastname: Espehaug
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium