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International Orthopaedics

, Volume 33, Issue 2, pp 381–385 | Cite as

A long-term follow-up study of the cementless THA with anatomic stem/HGPII cup with 22-mm head

  • Yutaka Nakoshi
  • Masahiro Hasegawa
  • Akihiro Sudo
  • Atsumasa Uchida
Original Article

Abstract

The anatomic femoral component and Harris-Galante porous II (HGPII) cup were developed to provide more reliable bone ingrowth. We performed 20 cementless total hip arthroplasties (THAs) with anatomic stem/HGPII cup with 22-mm head in 14 consecutive patients, and evaluated the clinical and radiological results for a mean follow-up of 12.8 years. The all-anatomically designed stem provided excellent clinical and radiographic results. Four acetabular components underwent revision: three for fracture of the locking mechanism and wear of the polyethylene liner and one for the locking mechanism failure with dislocation of the HGPII cup. The abduction angles of the four revised acetabular components were apparently higher. The survivorship 13 years after surgery was 78%. Our findings show good long-term results using the anatomic femoral component, while the HGPII cup combined with 22-mm head seems to have poor durability due to locking mechanism failure.

Keywords

Femoral Component Acetabular Component Radiolucent Line Thigh Pain Polyethylene Liner 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Le composant fémoral anatomique et la cupule Harris-Galante porous II (HGPII) ont été développés de façon à améliorer la repousse osseuse. Nous avons réalisé 20 prothèses totales de hanche sans ciment avec une queue anatomique et une cupule HGPII et un couple de friction avec une tête de 22 mm chez 14 patients consécutifs. Nous avons réalisé une évaluation clinique et radiologique des résultats après un suivi moyen de 12,8 ans. Toutes les pièces fémorales ont donné d’excellents résultats sur le plan clinique et radiographique. Cependant, 4 composants acétabulaires ont nécessité une révision, 3 pour fracture de mécanisme de verrouillage de l’insert et usure de l’insert, 1 pour défaut du verrouillage du mécanisme de la fixation de l’insert et luxation de la cupule. L’angle de verticalisation des 4 cupules révisées a été plus important. Le taux de survie à 13 ans a été de 78%. Nous pensons que cet implant donne de bons résultats à long terme sur le plan fémoral, il n’en est pas de même en ce qui concerne la cupule HGPII associée à une tête de 22 mm, celle-ci semble avoir une durée de vie diminuée du fait du défaut de mécanisme de blocage de l’insert.

References

  1. 1.
    Archibeck MJ, Berger RA, Jacobs JJ, Quigley LR, Gitelis S, Rosenberg AG, Galante JO (2001) Second-generation cementless total hip arthroplasty. Eight- to eleven-year results. J Bone Joint Surg Am 83:1666–1673PubMedGoogle Scholar
  2. 2.
    Bizot P, Larrory M, Witvoet J, Sedel L, Nizard R (2000) Press-fit metal-backed alumina sockets: a minimum 5-year follow-up study. Clin Orthop 379:134–142PubMedCrossRefGoogle Scholar
  3. 3.
    Callaghan JJ, Albright JC, Goetz DD, Olejniczak JP, Johnston RC (2000) Charnley total hip arthroplasty with cement. Minimum twenty-five-year follow-up. J Bone Joint Surg Am 82:487497Google Scholar
  4. 4.
    DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop 121:20–32PubMedGoogle Scholar
  5. 5.
    Diwan A, Drummond R (1997) Unusual cause of third-body wear in total hip arthroplasty. J Arthroplasty 12:586–588PubMedCrossRefGoogle Scholar
  6. 6.
    Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br) 69-B:45–55Google Scholar
  7. 7.
    Engh CA Jr, Culpepper WJ 2nd, Engh CA (1997) Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am 79:177–184PubMedCrossRefGoogle Scholar
  8. 8.
    Gaffey JL, Callaghan JJ, Pedersen DR, Goetz DD, Sullivan PM, Johnston RC (2004) Cementless acetabular fixation at fifteen years. A comparison with the same surgeon’s results following acetabular fixation with cement. J Bone Joint Surg Am 86:257–261PubMedGoogle Scholar
  9. 9.
    Garcia-Cimbrelo E, Munuera L (1992) Early and late loosening of the acetabular cup after low-friction arthroplasty. J Bone Joint Surg Am 74:1119–1129PubMedGoogle Scholar
  10. 10.
    Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141:17–27PubMedGoogle Scholar
  11. 11.
    Harris WH (1995) The problem is osteolysis. Clin Orthop 311:46–53PubMedGoogle Scholar
  12. 12.
    Hasegawa M, Sudo A, Uchida A (2006) Alumina ceramic-on-ceramic total hip replacement with a layered acetabular component. J Bone Joint Surg Br 77:833–835Google Scholar
  13. 13.
    Hodginson JP, Shelley P, Wroblewski BM (1988) The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties. Clin Orthop 228:105–109Google Scholar
  14. 14.
    Kawamura H, Bourne RB, Dunbar MJ, Rorabeck CH (2001) Polyethylene wear of the porous-coated anatomic total hip arthroplasty with an average 11-year follow-up. J Arthroplasty 16:116–121PubMedCrossRefGoogle Scholar
  15. 15.
    Kim YH, Kim VE (1993) Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Joint Surg Br 75:6–13PubMedGoogle Scholar
  16. 16.
    Lachiewicz PF, Soileau ES (2006) Polyethylene liner exchange of the Harris-Galante porous I and II acetabular components without cement: results and complications. J Arthroplasty 21:992–997PubMedCrossRefGoogle Scholar
  17. 17.
    Livermore J, IIstrup D, Morrey B (1990) Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg (Am) 72-A:518–528Google Scholar
  18. 18.
    Merle d’Aubigne R, Postel M (1954) Function results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg (Am) 36-A:451–475Google Scholar
  19. 19.
    Peters CL, Sullivan CL (2002) Locking mechanism failure in the Harris-Galante porous acetabular component associated with recurrent hip dislocation. J Arthroplasty 17:507–515PubMedCrossRefGoogle Scholar
  20. 20.
    Ragab AA, Kraay MJ, Goldberg VM (1999) Clinical and radiographic outcomes of total hip arthroplasty with insertion of an anatomically designed femoral component without cement for the treatment of primary osteoarthritis. A study with a minimum of six years of follow-up. J Bone Joint Surg Am 81:210–218PubMedGoogle Scholar
  21. 21.
    Sakalkale DP, Eng K, Hozack WJ, Rothman RH (1999) Minimum 10-year results of a tapered cementless hip replacement. Clin Orthop 362:138–144PubMedGoogle Scholar
  22. 22.
    Thanner J, Karrholm J, Herberts P, Malchau H (2000) Hydroxyapatite and tricalcium phosphate-coated cups with and without screw fixation: a randomized study of 64 hips. J Arthroplasty 15:405–412PubMedCrossRefGoogle Scholar
  23. 23.
    Urban RM, Jacobs JJ, Sumner DR, Peters CL, Voss FR, Galante JO (1996) The bone-implant interface of femoral stems with non-circumferential porous coating. J Bone Joint Surg Am 78:1068–1081PubMedGoogle Scholar
  24. 24.
    Vresilovic EJ, Hozack WJ, Rothman RH (1996) Incidence of thigh pain after uncemented total hip arthroplasty as a function of femoral stem size. J Arthroplasty 11:304–311PubMedCrossRefGoogle Scholar
  25. 25.
    Xenos JS, Callaghan JJ, Heekin RD, Hopkinson WJ, Savory CG, Moore MS (1999) The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up. J Bone Joint Surg Am 81:74–82PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Yutaka Nakoshi
    • 1
  • Masahiro Hasegawa
    • 1
  • Akihiro Sudo
    • 1
  • Atsumasa Uchida
    • 1
  1. 1.Department of Orthopedic SurgeryMie University Graduate School of MedicineTsu City, MieJapan

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