Five-year clinical and radiographic follow-up of the uncemented long-term stable fixation total hip arthroplasty. 1998

P F Sharkey, and R L Barrack, and D E Tvedten
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Thirty-nine uncemented porous-coated long-term stable fixation total hip prostheses with a minimum 5-year follow-up, were retrospectively reviewed for clinical and radiographic outcome. Clinical evaluation was performed using the modified Harris Hip Score. Additionally, all patients completed a satisfaction questionnaire. Anteroposterior view and lateral view radiographs were obtained and compared with immediate postoperative films utilizing the Hip Society radiographic evaluation form for uncemented implants. The follow-up period averaged 69 months (range, 60-87 months). At the most recent follow-up visit Harris Hip Scores averaged 88 points (range, 68-100 points), with 79% good or excellent results. Of the 8 hips (6 patients) with fair or poor results, 5 patients (6 hips) were Charnley category C patients. All patients were satisfied with their surgery and all, but 2 stated that their function had significantly improved. The incidence of significant thigh pain was 13%. Calcar osteolysis was present in 13 of 39 femurs with the majority of cases being minimal. All but one femoral component demonstrated bone ingrowth. There was no distal femoral osteolysis present and no femoral revisions have been performed or are planned. Acetabular osteolysis was present in 7 of 39 hips, with 4 of the 7 centered around acetabular fixation screws. All patients who had acetabular bone loss had some degree of femoral osteolysis. Thus far, one patient has required acetabular revision secondary to osteolysis. Acetabular osteolysis in this series was more profound than on the femoral side and two other patients are being considered for revision due to pelvic side osteolysis. In conclusion, the uncemented long-term stable fixation femoral component proved to be durable in this series of patients. The circumferential porous coating on the femoral implant may protect against distal osteolysis. A concerning rate of severe pelvic osteolysis and impending failure was noted and may lead to a greater need for revision surgery with longer follow-up.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010014 Osteolysis Dissolution of bone that particularly involves the removal or loss of calcium. Osteolyses
D010149 Pain, Postoperative Pain during the period after surgery. Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011474 Prosthesis Design The plan and delineation of prostheses in general or a specific prosthesis. Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002484 Cementation The joining of objects by means of a cement (e.g., in fracture fixation, such as in hip arthroplasty for joining of the acetabular component to the femoral component). In dentistry, it is used for the process of attaching parts of a tooth or restorative material to a natural tooth or for the attaching of orthodontic bands to teeth by means of an adhesive. Cementations
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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