Primary Total Hip Arthroplasty with a Porous-Coated Acetabular Component

A Concise Follow-up, at a Minimum of Twenty Years, of Previous Reports*
Craig J. Della Valle, MD1, Nathan W. Mesko, MD1, Laura Quigley, MS1, Aaron G. Rosenberg, MD1, Joshua J. Jacobs, MD1 and Jorge O. Galante, MD1

The Journal of Bone and Joint Surgery (American). 2009;91:1130-1135. doi:10.2106/JBJS.H.00168 © 2009 The Journal of Bone and Joint Surgery, Inc.

Abstract: We 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.