The porous coated anatomic total hip replacement - A ten to fourteen-year follow-up study of a cementless total hip arthroplasty

Citation
H. Kawamura et al., The porous coated anatomic total hip replacement - A ten to fourteen-year follow-up study of a cementless total hip arthroplasty, J BONE-AM V, 83A(9), 2001, pp. 1333-1338
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
ISSN journal
0021-9355 → ACNP
Volume
83A
Issue
9
Year of publication
2001
Pages
1333 - 1338
Database
ISI
SICI code
0021-9355(200109)83A:9<1333:TPCATH>2.0.ZU;2-G
Abstract
Background: We previously reported our two and five-year results of arthrop lasty with the Porous Coated Anatomic total hip prosthesis. We now report o n the performance of this prosthesis at ten to fourteen years. Methods: The results of 311 total hip replacements in which a Porous Coated Anatomic prosthesis was inserted without cement in 279 patients were analy zed prospectively. The average age of the patients at the time of the repla cement was sixty-one years (range, twenty to eighty-one years). Sixty-four patients (seventy-six hips) died postoperatively. Forty-five patients (fort y-seven hips) were lost to follow-up, and four were excluded because of the ir medical condition. One hundred and sixty-eight patients (187 hips) were followed for ten to fourteen years (average, twelve years). Seventeen of th ose patients (seventeen hips) had a revision. Results: The overall survival rate (with any revision as the end point) was 90.0% +/- 5.4% at fourteen years, with an average Harris hip score of 85 /- 14 points. The prevalence of thigh pain was 36% (fifty-six of 157) in th e late period (more than ten years postoperatively). Radiographs showed sta ble fixation, with bone ingrowth, of 83% (130) of the 156 acetabular compon ents and 88% (137) of the 156 femoral components at the latest follow-up ev aluation. Men had a significantly higher rate of femoral osteolysis. than d id women (p < 0.001). The rates of acetabular and femoral osteolysis associ ated with 32-mm femoral heads (49% [twenty-three] of forty-seven and 70% [t hirty-three] of forty-seven, respectively) were significantly higher (p < 0 .01) than those associated with 26-mm heads (26% [twenty-eight] of 109 and 30% [thirty-three] of 109, respectively). Despite this, revision (removal o r exchange of components) was not directly related to head size; instead, i t was related to polyethylene thickness. Conclusions: There have been persistent problems with the Porous Coated Ana tomic hip system, including thigh pain and an increasing prevalence of oste olysis with time. Revision because of aseptic loosening was related more to the thickness of the polyethylene liner than to the size of the femoral he ad. Femoral heads with a 32-mm diameter did not increase the risk for revis ion provided that an adequate thickness of polyethylene had been used.