title: No improvement in long-term wear and revision rates with the second-generation Biomet cup (RingLoc) in young patients: 141 hips followed for median 12 years.
abstract: BACKGROUND
  A number of excellent results with the cementless titanium femoral component of the Mallory Head Total Hip Replacement have been published. Unfortunately, these excellent results have been counteracted by the poor performance of the cementless titanium acetabular components. In 1994, the HexLoc acetabular component was replaced with a second-generation design, the RingLoc. We hypothesized that the new generation would have improved the results.
  
  
  METHODS
  We retrospectively studied 111 consecutive patients (150 hips) younger than 55 years. Median follow-up time was 14 (6-18) years for the HexLoc and 10 (1-14) years for the RingLoc. 7 patients were lost to follow-up and 7 patients died. The 10-year survival rate, radiographic liner wear, and radiographic signs of prosthesis failure were compared between the 2 acetabular components.
  
  
  RESULTS
  The Kaplan-Meier survival estimate with revision for any reason as the endpoint showed a 10-year survival of 89% (95% CI: 81-97) for the HexLoc and 92% (CI: 85-98) for the RingLoc. The mean annual wear rate for the HexLoc was 0.16 (SD 0.16) mm and it was 0.15 (0.1) mm for the RingLoc (p = 0.3). The radiographic signs of failure were equally distributed between the 2 groups.
  
  
  CONCLUSIONS
  Compared to the HexLoc type, the RingLoc system did not improve the mean percentage survival at 10 years; nor did it reduce the liner wear. Despite correction of the known design flaws in the HexLoc design, the RingLoc system did not show a clinically relevant improvement compared to its predecessor.
authors: Department of Orthopaedic Surgery, Leiden University Medical Center, the Netherlands.
authors: Bart
authors: B
authors: Boesenach
authors: Huub J L
authors: HJ
authors: van der Heide
authors: Rob G H H
authors: RG
authors: Nelissen
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult