Primary total hip arthroplasty with a porous-coated acetabular component. A concise follow-up, at a minimum of twenty years, of previous reports.
We previously reported the seven and fifteen-year results of the use of a porous-coated acetabular metal shell inserted without cement in a consecutive series of 204 primary total hip arthroplasties. In the present study, we evaluated the longer-term outcomes of these arthroplasties at a minimum follow-up time of twenty years. One hundred and fourteen (92%) of the 124 hips available for study had retained the original acetabular metal shell. A total of five acetabular components had been revised for aseptic loosening or had radiographic evidence of definite loosening. Fourteen hips with well-fixed acetabular shells required a change of the modular acetabular liner because of excessive wear and/or for the treatment of osteolysis, and liner changes have been recommended for another eight hips. The twenty-year rate of survival of the metal shell, with failure defined as revision because of loosening or radiographic evidence of loosening, was 96% (95% confidence interval, 94% to 98%). Cementless acetabular reconstruction continues to provide durable fixation at twenty years postoperatively. Wear-related complications continue to be the major mode of failure.
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA. craigdv@yahoo.com
Craig J
CJ
Della Valle
Nathan W
NW
Mesko
Laura
L
Quigley
Aaron G
AG
Rosenberg
Joshua J
JJ
Jacobs
Jorge O
JO
Galante
D000077:Acetabulum; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D013997:Time Factors