Press-fit metal-backed alumina sockets - A minimum 5-year followup study

Two hundred thirty-four consecutive alumina-on-alumina hip replacements usi ng a press-fit metal-backed socket, performed on 214 patients (98 women, 11 6 men) have been reviewed. These included 201 primary procedures and 33 rev ision procedures. The median age of the patients at the time of surgery was 62 Sears (range, 21-83 years). Fourteen patients (16 hips) died from unrel ated causes. Eleven patients (11 hips) underwent a total hip arthroplasty r evision for recurrent dislocation (one hip), deep infection (two hips), fra cture of alumina femoral head (one hip), persistent hip pain (one hip) and aseptic loosening (six hips). The survival rate after 9 years was 93.4% whe n revision of the prosthesis was considered the end point, and 97.4% if rev ision of the prosthesis for aseptic loosening was considered the end point. Results were assessed in the surviving patients with a minimal 5-year foll owup (170 patients, 184 hips). At the median followup of 7.8 years, the ave rage Merle d'Aubigne and Postel score had improved from 11.9- to 17.7. Resu lts were graded as excellent in 148 hips (80.5%), very good in 31 hips (17% ), good in two hips (1%), and fair in three hips (1.5%), Radiologic data we re documented for 134 patients (143 hips). Three sockets (2%) had a complet e and nonprogressive radiolucent line less than I-mm thick, one stem (0.7%) had lucencies involving five zones, and two stems (1.4%) had isolated femo ral osteolysis, Neither component migration nor acetabular osteolysis were detected. A press-fit metal-backed socket may offer a good solution for alu mina socket fixation when combined with a careful surgical technique of imp lantation.