Primary Total Hip Arthroplasty with a Porous-Coated Acetabular Component: A Concise Follow-up, at a Minimum of Twenty Years, of Previous Reports

• Published in: Journal of bone and joint surgery. American volume Vol. 91; no. 5; pp. 1130 - 1135
• Main Authors: Della Valle, Craig J, Mesko, Nathan W, Quigley, Laura, Rosenberg, Aaron G, Jacobs, Joshua J, Galante, Jorge O
• Format: Journal Article
• Language: English
• Published: Boston, MA Copyright by The Journal of Bone and Joint Surgery, Incorporated 01-05-2009; Journal of Bone and Joint Surgery Incorporated
• Subjects: Acetabulum; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - instrumentation; Biological and medical sciences; Diseases of the osteoarticular system; Follow-Up Studies; Hip Prosthesis; Humans; Medical sciences; Middle Aged; Orthopedic surgery; Prosthesis Design; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Hip prosthesis; Orthopedic surgery; Treatment; Coated material
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/JBJS.H.00168

AbstractWe 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.Level of EvidenceTherapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.