Background: The long-term results of total hip arthroplasty without
cement have been reported only rarely. The purpose of the present study was to
evaluate the minimum ten-year results of primary total hip arthroplasty
performed with use of a proximally porous-coated, plasma-sprayed,
straight-stemmed, titanium-alloy femoral component.
Methods: The clinical and radiographic results of a consecutive
series of 105 total hip replacements in ninety-five patients were reviewed ten
to twelve years postoperatively. The diagnosis was osteoarthritis for
seventy-seven hips (73%). The clinical result was evaluated on the basis of
the Harris hip score, complications, and thigh pain. A detailed radiographic
analysis was performed at each follow-up visit. Kaplan-Meier analysis was
performed to evaluate the survival of the femoral component.
Results: The average Harris hip score improved from 46 points
preoperatively to 92 points postoperatively. The average pain score at the
time of the most recent follow-up was 42 points, with eighty-three hips (79%)
rated as pain-free. Thigh pain was identified in only two patients. All
radiolucent lines were seen around the tip of the stem. All hips had some
degree of femoral remodeling consistent with osseous ingrowth. No femoral
component was revised, and no femoral component had evidence of loosening.
Eight acetabular components were revised because of loosening and wear, and
one was revised because of recurrent dislocation. One focal femoral osteolytic
lesion was seen.
Conclusions: This femoral component afforded durable fixation at ten
to twelve years after primary total hip arthroplasty.
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.