The purpose of the present study was to analyze the longer-term results for a previously reported cohort of patients who were managed with cementless acetabular fixation at the time of revision arthroplasty. Sixty-one consecutive revision total hip arthroplasties were performed in fifty-five patients with use of a cementless acetabular component and screw-augmented fixation. This series was evaluated at minimum of twenty years. Twelve patients (fourteen hips) were living at twenty years. In this group of sixty-one arthroplasties, there were nineteen revisions in fourteen hips (22.9%) during the follow-up period, but no revisions were performed because of loosening of the acetabular component and no additional cups had loosened since the time of the last report at a minimum of ten years. Two components had previously been reported as loose and had migrated, but neither had been revised at the time of the latest follow-up. The minimum twenty-year follow-up of these cementless acetabular components demonstrated durable long-term fixation. The survival rate was 100% with revision of the shell because of aseptic loosening as the end point and 97.7% (95% confidence interval, ±8.8%) with radiographic evidence of loosening as the end point. The authors continue to use cementless acetabular fixation with screw augmentation for most revision total hip arthroplasty procedures.Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.