Background: Although cementless acetabular components
are routinely used in revision hip surgery, few investigators have
evaluated the retention and efficacy of these components in the
long term. In the current study, the clinical and radiographic outcomes
of a series of arthroplasties performed by one surgeon with a cementless
acetabular component were assessed at a minimum of ten years.
Methods: From 1986 through 1988, sixty-one
consecutive revision total hip arthroplasties were performed in
fifty-five patients because of aseptic failure of one or both components
of a prosthesis in which both components had been cemented. Twenty-eight
patients (thirty-two hips) were alive at a mean of 12.9 years (range,
11.5 to 14.3 years) after the operation. In all of the patients,
the acetabular component was revised to a porous-coated
Harris-Galante component inserted without cement, and the
femoral component was revised to an Iowa component affixed with
contemporary cementing techniques. The hips were evaluated clinically
and radiographically at a minimum of ten years subsequent to the
index revision. No hips were lost to follow-up.
Results: None of the acetabular components required
revision because of aseptic loosening. Two hips (3%) demonstrated
radiographic evidence of aseptic loosening of the acetabular component.
The polyethylene liner was exchanged during the follow-up
period in eight hips.
Conclusion: After a minimum of ten years of follow-up,
cementless acetabular fixation in revision hip arthroplasty had
produced durable results that were markedly better than those reported for
acetabular fixation with cement.