Cementless acetabular replacement in the young - A 5-to 10-year prospective study

This article presents a prospective clinical and radiologic review of 55 to tal hip replacements in 50 patients in which the cementless Harris-Galante porous-coated acetabular component was used. All patients were 50 years of age or younger. The cups were inserted by 15 different surgeons. The minimu m followup was 5 years, with a mean of 7 years. No acetabular component has been revised for loosening, and none have migrated. Three (5.5%) cups have progressive bone-component radiolucent lines, two (3.6%) of which are comp lete. Six (10.9%) acetabular liners have been replaced for excessive polyet hylene wear, and an additional four (7.3%) show sufficient wear to produce obvious radiographic eccentricity of the femoral head. All of the revised l iners had 32-mm femoral heads and an initial polyethylene thickness of less than 6 mm. Although the results reflect excellent fixation of this compone nt in the medium term, the incidence of exchange of the polyethylene liner for excessive wear is unacceptably high. The reduction in polyethylene thic kness associated with the use of a metal-backed component and a 32-mm artic ulation was one of the factors contributing to the accelerated wear pattern s seen in this series.