We previously reported the seven-to-ten-year results of the use of a
porous-coated acetabular metal shell in a consecutive series of 204 primary
total hip arthroplasties. In the present study, we evaluated the longer-term
outcomes of these arthroplasties, at fifteen to eighteen years. One hundred
and thirty-six (96%) of the 142 hips available for study retained the original
acetabular metal shell. Three of the 142 metal shells failed secondary to
aseptic loosening. Ten hips (7%) required a change of the modular acetabular
liner because of excessive wear or for the treatment of osteolysis. The
fifteen-year rate of survival of the metal shell, with failure defined as
revision because of loosening or radiographic evidence of loosening, was 99%.
The rate of survival of cementless acetabular reconstructions was excellent at
fifteen years, although osteolysis and reoperations were noted to occur much
more frequently as the duration of follow-up increased. The majority of the
complications were related to wear of the polyethylene liner.
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.