Minimum ten-year follow-up of a straight-stemmed, plasma-sprayed, titanium-alloy, uncemented femoral component in primary total hip arthroplasty

John B Meding, E Michael Keating, Merrill A Ritter, Philip M Faris, Michael E Berend
Journal of Bone and Joint Surgery. American Volume 2004, 86-A (1): 92-7

BACKGROUND: The long-term results of total hip arthroplasty without cement have been reported only rarely. The purpose of the present study was to evaluate the minimum ten-year results of primary total hip arthroplasty performed with use of a proximally porous-coated, plasma-sprayed, straight-stemmed, titanium-alloy femoral component.

METHODS: The clinical and radiographic results of a consecutive series of 105 total hip replacements in ninety-five patients were reviewed ten to twelve years postoperatively. The diagnosis was osteoarthritis for seventy-seven hips (73%). The clinical result was evaluated on the basis of the Harris hip score, complications, and thigh pain. A detailed radiographic analysis was performed at each follow-up visit. Kaplan-Meier analysis was performed to evaluate the survival of the femoral component.

RESULTS: The average Harris hip score improved from 46 points preoperatively to 92 points postoperatively. The average pain score at the time of the most recent follow-up was 42 points, with eighty-three hips (79%) rated as pain-free. Thigh pain was identified in only two patients. All radiolucent lines were seen around the tip of the stem. All hips had some degree of femoral remodeling consistent with osseous ingrowth. No femoral component was revised, and no femoral component had evidence of loosening. Eight acetabular components were revised because of loosening and wear, and one was revised because of recurrent dislocation. One focal femoral osteolytic lesion was seen.

CONCLUSIONS: This femoral component afforded durable fixation at ten to twelve years after primary total hip arthroplasty.

LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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