TOTAL HIP-ARTHROPLASTY PERFORMED WITH INSERTION OF THE FEMORAL COMPONENT WITH CEMENT AND THE ACETABULAR COMPONENT WITHOUT CEMENT - 10-YEAR TO 13-YEAR RESULTS

Fifty-two consecutive primary total hip arthroplasties were performed in forty-seven unselected patients by one surgeon. The prosthesis incl uded a hemispherical porous-coated acetabular component, inserted with out cement and with the use of screws through three peripheral flanges , and a femoral component, inserted with a so-called second-generation cementing technique. No patient was lost to radiographic follow-up? a nd the clinical result was known for all patients. The average age at the time of the index operation was fifty-seven years (range, twenty-n ine to seventy-nine years). Four patients (four hips) who died mere la st examined less than ten gears postoperatively (the minimum follow-up period for this study) and one hip was revised, leaving forty-seven n on-revised hips in forty-two surviving patients who were followed for at least ten years. The duration of clinical follow-up of these forty- two patients averaged 12.3 years (range, 10.8 to 13.3 years), and the duration of radiographic follow-up averaged 12.1 rears (range, 10.0 to 13.0 years). One (2 per cent) of the original fifty-two hips was revi sed for late recurrent dislocation, without loosening, 9.7 years after the index arthroplasty. The rate of dislocation was relatively high ( 13 per cent; seven hips), and we believed it to be related to the shal low-chamfer acetabular design combined with the small femoral head. At the time of the latest follow-up, no femoral component was loose. One (2 per cent) of the fifty-two acetabular components was loose accordi ng to radiographic criteria, but the hip functioned well (Harris hip s core, 94 points) 12.4 years after the index arthroplasty. Pelvic osteo lysis developed in one hip (2 per cent); femoral osteolysis, in eight (15 per cent); and distal femoral osteolysis, in three (6 per cent). T he average Harris hip score for the forty-seven non-revised hips incre ased from 48 points (range, 26 to 63 points) preoperatively to 89 poin ts (range, 67 to 100 points) at the time of the most recent follow-up. Forty (85 per cent) of the forty-seven hips had a good or excellent r esult, whereas five (11 per cent) had a fair result (score, 74 to 79 p oints) and two (4 per cent) had a poor result (score, 67 and 69 points ). The hybrid primary total hip arthroplasty resulted in very good cli nical function at ten to thirteen years, although the rate of dislocat ion was high.