TOTAL HIP-ARTHROPLASTY WITH USE OF SO-CALLED 2ND-GENERATION CEMENTINGTECHNIQUES - A 15-YEAR-AVERAGE FOLLOW-UP-STUDY

One hundred and forty-one patients (162 hips) had a standard primary t otal hip arthroplasty with a grit-blasted femoral component and use of so-called second-generation cementing techniques, No patient was lost to follow-up, Fifty-one patients (sixty hips) died within fourteen ye ars after the index: operation. The remaining ninety patients (102 hip s) were followed for a minimum of fourteen years. Of the fifty-one pat ients (sixty hips) who died within fourteen years, three patients (thr ee hips; 5 per cent) had had a revision: one, because of aseptic loose ning of the acetabular component; one, because of aseptic loosening of the femoral component; and one, because of aseptic loosening of both components, Of the ninety patients (102 hips) who were alive fourteen years or more (average duration of follow-up, fifteen years) after the arthroplasty, one patient (two hips; 2 per cent) had a revision becau se of bilateral aseptic loosening of the femoral component, In seven p atients (seven hips; 7 per cent), the femoral component was loose acco rding to radiographic criteria but was not revised, For the entire gro up of 162 hips, four femoral components (2 per cent) were revised beca use of aseptic loosening. In contrast, the rate of aseptic loosening o f the acetabular component was higher and continued to increase, Of th e eighty-one hips with an all-polyethylene acetabular component in the patients who were alive at fourteen years or more, eight (10 per cent ) had a revision because of aseptic loosening, In addition, twenty-eig ht (42 per cent) of the sixty-seven all-polyethylene acetabular compon ents that were in place after fourteen years or more, and for which th ere were current radiographs, were loose. Femoral components implanted with the use of second-generation cementing techniques appear to have fared much better than acetabular components that were inserted with similar techniques in this series of patients, A thin (less than one-m illimeter) mantle of cement around the femoral component and defects i n the mantle of cement were associated with increased loosening of the femoral component.