title: 19 years outcome after cementless total hip arthroplasty with spongy metal structured implants in patients younger than 65 years.
abstract: Cementless fixation of total hip arthroplasties (THAs) is often favored in young, high-demanding patients due to the conservation of valuable bone-stock and easier revision if loosening has occurred. Long-term outcome data of the spongy metal structured implant used in the present study in patients younger than 65 years are still lacking.
  
  
  
  We conducted a retrospective chart review and functional investigation (Merle d'Aubigné score, SF-12) of patients younger than 65 years at implantation treated with a spongy metal structured THA (n = 79) from one orthopedic university center from 1985 to 1989.
  
  
  
  At a 19-year mean follow-up (range: 15.3 - 21.3 years), the overall stem survival rate was 93.7 %, and the overall cup survival rate was 82.3 %. Revision surgeries of the stem were performed in all cases for aseptic loosening at an average of 15.3 ± 3.5 years after implantation. Acetabular components were revised for aseptic loosening and recurrent dislocation after inlay revision on an average of 11.8 ± 4.7 years after implantation. No other device related complications occurred within the 19-year follow-up period. No correlation was found between time of revision and gender or age. Clinical outcome scores (Merle d'Aubigné score, SF-12) revealed excellent to good results of the implanted THAs in 87 % of patients.
  
  
  
  We conclude that spongy metal structured cementless THAs implanted in young patients have an excellent survival and provide trustworthy clinical results at 19 years of follow-up.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinik Schleswig Holstein, Arnold Heller Strasse 3, 24105, Kiel, Germany. gerdesmeyer@medbaltic.de.
authors.forename: Ludger
authors.initials: L
authors.lastname: Gerdesmeyer
authors.affiliation: Sydney Adventist and Norwest Hospitals, University of New South Wales, 116 Macquarie Street, Parramatta, 2150, NSW, Australia.
authors.forename: Munjed
authors.initials: M
authors.lastname: Al Muderis
authors.affiliation: Klinik für Orthopädie und Sportorthopädie am Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr.22, 81675, Munich, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Gollwitzer
authors.affiliation: Klinik für Orthopädie und Sportorthopädie am Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr.22, 81675, Munich, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Harrasser
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinik Schleswig Holstein, Arnold Heller Strasse 3, 24105, Kiel, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stukenberg
authors.affiliation: Prince of Wales Private Hospital Sydney, Barker Street, Randwick, 2031, NSW, Australia.
authors.forename: Maria-Angela
authors.initials: MA
authors.lastname: Clifford
authors.affiliation: Klinik für Orthopädie und Sportorthopädie am Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr.22, 81675, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Toepfer
mesh_terms: D000077:Acetabulum; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data*; D001847:Bone Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D016062:Porosity; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Cementless; Spongy metal structured; Total hip arthroplasty; Young patients