The 21- to 27-year results of the Harris-Galante cementless total hip arthroplasty.

BACKGROUND: The Harris-Galante total hip arthroplasty (THA) is a first-generation cementless THA with a porous coating for biological fixation of the implant. Many studies report excellent long-term results for the acetabular cup, but few long-term studies exist for the femoral stem because of relatively poor short-term and midterm results. Here we present the 21- to 27-year results of the cup and the stem of the Harris-Galante THA.

METHODS: From 1985 to 1991, 102 Harris-Galante THAs were inserted in 82 patients. At the time of the THA, the mean patient age was 54 years (range, 20-78 years). The primary diagnosis was secondary osteoarthritis due to developmental hip dysplasia (69 [68%] hips). The Japanese Orthopaedic Association (JOA) hip score and thigh pain were measures of clinical outcome. Radiographic review was performed retrospectively. Implant survival was evaluated by Kaplan-Meier analysis.

RESULTS: Of 102 hips, 35 hips were from 31 deceased patients, 5 patients (6 hips) were lost to follow-up, 12 hips were revised, and 49 hips were from patients living at the latest follow-up. Among the living patients, 36 hips had a clinical evaluation and 42 hips had a radiograph obtained more than 21 years. The JOA hip score improved from 42 points preoperatively to 83.5 points at the latest follow-up. Thigh pain was reported in 13 hips. One cup and four stems were loose at the latest radiographic review. Most cup revisions were related to acetabular osteolysis. Fifteen hips showed severe stress shielding. Kaplan-Meier analysis of survivorship with any revision, acetabular reoperation, stem revision, and stem loosening as the end point was 87.0%, 90.3%, 95.7% and 86.4%, respectively, at 24.6 years.

CONCLUSIONS: Long-term implant survival and clinical results of the Harris-Galante THA were good. Acetabular osteolysis-related cup loosening was a problem of the cup. Loosening, thigh pain, and stress shielding were problems of the stem.