Background: Revisions of the acetabular component of a total hip
arthroplasty have a higher rate of complications, particularly loosening and
dislocation, than do primary procedures. The purpose of this study, in which
the results of a consecutive series of revisions performed with the
Harris-Galante Porous acetabular component by a single surgeon were evaluated
at an average of twelve years, was to quantify the complications and outcomes
of acetabular revision.
Methods: Clinical and radiographic results were evaluated to assess
loosening, lysis, radiolucencies, and trochanteric union in 188 hips (170
patients) treated between 1984 and 1990. One hundred and twenty-two hips in
110 patients were followed for at least ten years, which was required for
inclusion in the study. Thirty-one patients (thirty-six hips) died less than
ten years postoperatively, and twenty-nine patients (thirty hips) were lost to
or refused to return for follow-up.
Results: The average Harris hip score was 78 points at an average of
12.5 years after revision, which was a 29-point improvement compared with the
preoperative score. The rate of repeat revision because of aseptic loosening
of the acetabular shell was 4% (five of 122). The rate of repeat revision of
the shell for any reason was 15% (eighteen of 122). Eight unrevised sockets
were loose radiographically, for a total rate of aseptic loosening of 11%
(thirteen of 122).
Conclusions: This study demonstrated that most acetabular revisions
with this cementless hemispherical socket were successful. Few structural
grafts and no cages were used.
Level of Evidence: Therapeutic study, Level IV (case
series [no, or historical, control group]). See Instructions to Authors for a
complete description of levels of evidence.