TREATMENT OF COMPLICATIONS IN PRIMARY CEMENTLESS TOTAL HIP-ARTHROPLASTY

Five hundred eight consecutive cases (481 patients) treated with the e xtensively porous coated Anatomic Medullary Locking prosthesis were fo llowed for an average of 9 years (range, 5-14 years), Thirty-one (6%) hips were lost to followup and 33 (7%) hips had complications that req uired revision surgery, The indications for revision were symptomatic stem loosening (six cases), symptomatic cup loosening (five cases), as ymptomatic periarticular osteolysis (seven cases); trochanteric fractu re through an osteolytic cyst (four cases), polyethylene fracture (fiv e cases), sepsis (one case), and heterotopic ossification (one case), The surgical treatment of these complications is described. After thes e revisions, 11 (33%) cases had additional complications, most commonl y a dislocation. Four required a second revision, Questionnaires and p hysical examinations were used to compare the outcome of the cases req uiring revision with the outcome of those that did not, There were no differences in patient satisfaction between cases requiring revision s urgery and those that did not (97% and 95% patient satisfaction, respe ctively), Function was also similar between the two groups, with 93% r eporting increased function in each group.