Skip to main content
SpringerLink
Log in

Long-term results of uncemented acetabular cups with an ACS polyethylene liner. A 14–16-year follow-up study

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

We assessed the clinical and radiographic results of 40 porous-coated acetabular cups with an Acetabular Cup System polyethylene liner over a minimum 14-year follow-up. Femoral head penetration was estimated using a software package. Fifteen cups were revised, 11 due to polyethylene liner rupture. All cups but two were radiographically stable, and 11 hips showed acetabular osteolysis. The overall femoral head penetration rate in hips without liner fracture with reference to the early penetration point was 0.1188±0.070 mm per year. Polyethylene liner fractures were associated with higher early femoral head penetration (P<0.0001) and a vertical cup position (P=0.0016). The 14-year survival without cup revision for any reason was 63.9%, 71.8% with no ACS polyethylene liner fracture and 65.3% with no acetabular osteolysis. Most cups showed a good clinical outcome in general, but major Acetabular Cup System liner failure and osteolysis were frequent. Patients with the ACS cups still in place should be monitored closely.

Résumé

Nous présentons les résultats de 40 cupules acétabulaires à revêtement poreux avec un noyau en polyéthylène « Acetabular Cup System » (ACS), à un recul minimum de 14 ans. La pénétration de la tête fémorale était estimée par un logiciel particulier. Quinze cupules étaient révisées dont 11 à cause d’une rupture du polyéthylène. Toutes les cupules sauf 2 étaient radiologiquement stable et 11 hanches montraient une ostéolyse acétabulaire. La vitesse de pénétration de la tête dans les cupules sans rupture était de 0,1188±0,070 mm par an. Les ruptures du polyéthylène étaient en rapport avec une importante pénétration précoce (P<0,0001) et une position verticale de la cupule (P=0,0016). La survie sans révision à 14 ans était de 63,9%, sans rupture du PE de 71,8% et sans ostéolyse de 65,3%. La plupart des cupules avaient une bonne évolution clinique mais la faillite du noyau en polyéthylène et l’ostéolyse étaient fréquentes. Les patients porteurs de cupule ACS doivent être suivis minutieusement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Astion DJ, Saluan P, Stulberg BN, Rimnac CM, Li S (1996) The porous-coated anatomic total hip prosthesis: Failure of the metal-backed acetabular component. J Bone Joint Surg Am 78:755–766

    PubMed  CAS  Google Scholar 

  2. Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness and material on stresses in ultra-high molecular weight components for total joint replacement. J Bone Joint Surg Am 68:1041–1051

    PubMed  CAS  Google Scholar 

  3. Berry DJ, Barnes CL, Scott RD, Cabanela ME, Poss R (1994) Catastrophic failure of the polyethyhlene liner of uncemented acetabular components. J Bone Joint Surg Br 76:575–578

    PubMed  CAS  Google Scholar 

  4. Bono JV, Sanford L, Toussaint JT (1994) Severe polyethylene wear in total hip arthroplasty. Observations from retrieved AML Plus hip implants with an ACS polyethylene liner. J Arthroplasty 9:119–125

    Article  PubMed  CAS  Google Scholar 

  5. Cruz-Pardos A, García-Cimbrelo E (2001) The Harris-Galante total hip arthroplasty. A minimum 8-year follow-up. J Arthroplasty 16:586–597

    Article  PubMed  CAS  Google Scholar 

  6. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop 121:20–32

    PubMed  Google Scholar 

  7. Devane PA, Bourne RB, Rorabeck CH, Hardie RM, Horne JG (1995) Measurement of polyethylene wear in metal backed cups: Three dimensional technique. Clin Orthop 319:303–316

    PubMed  Google Scholar 

  8. Devane PA, Horne JG, Martin K, Coldham G, Krause B (1997) Three-dimensional polyethylene wear of a press-fit titanium prosthesis. Factors influencing generation of polyethylene debris. J Arthroplasty 12:256–266

    Article  PubMed  CAS  Google Scholar 

  9. Dowd JE, Sychterz CJ, Young AM, Engh CA (2000) Characterization of long-term femoral-head penetration rates. Association with and prediction of osteolysis. J Bone Joint Surg Am 82:1102–1107

    PubMed  Google Scholar 

  10. Goetz DD, Smith JJ, Harris WH (1994) The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. J Bone Joint Surg Am 76:1121–1128

    PubMed  CAS  Google Scholar 

  11. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components. Clin Orthop 171:17–27

    Google Scholar 

  12. Hamadouche M, Witvoet J, Porcher R, Meunier A, Sedel L, Nizard R (2001) Hydroxyapatite-coated versus grit blasted femoral stems. A prospective, randomised study using EBRA-FCA. J Bone Joint Surg Br 83:979–987

    Article  PubMed  CAS  Google Scholar 

  13. Harris WH (1995) The problem is osteolysis. Clin Orthop 311:46–53

    PubMed  Google Scholar 

  14. Hui AJ, McCalden RW, Martell JM, MacDonald SJ, Bourne RB, Rorabeck CH (2003) Validation of two- and three-dimensional radiographic techniques for measuring polyethylene wear after total hip arthroplasty. J Bone Joint Surg Am 85:505–511

    PubMed  Google Scholar 

  15. Johnston RC, Fitzgerald RH, Harris WH, Poss R, Müller ME, Sledge CB (1990) Clinical and radiographic evaluation of total hip arthroplasty. A standard system of terminology for reporting results. J Bone Joint Surg Am 72:161–168

    PubMed  CAS  Google Scholar 

  16. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Statistc Assn 53:457–481

    Article  Google Scholar 

  17. Manning DW, Chiang PP, Martell JM, Galante JO, Harris WH (2005) In vivo comparative wear study of traditional and highly cross-linked polyethylene in total hip arthroplasty. J Arthroplasty 20:880–886

    Article  PubMed  Google Scholar 

  18. Martell JM, Berdia S (1997) Determination of polyethylene wear in total hip replacements with use of digital radiographs. J Bone Joint Surg Am 79:1635–1641

    PubMed  CAS  Google Scholar 

  19. Massin P, Schmidt L, Engh CA (1989) Evaluation of cementless acetabular component migration. An experimental study. J Arthroplasty 4:245–251

    Article  PubMed  CAS  Google Scholar 

  20. Merle D’Aubigné R, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36:451–475

    Google Scholar 

  21. Orishimo KF, Claus AM, Sychterz CJ, Engh CA (2003) Relationship between polyethylene wear and osteolysis in hips with a second-generation porous-costed cementless cup after seven years of follow-up. J Bone Joint Surg Am 85:1095–1099

    PubMed  Google Scholar 

  22. Patil S, Bergula A, Chen PC, Colwell CW Jr, D’Lima DD (2003) Polyethylene wear acetabular component orientation. J Bone Joint Surg Am 85(Suppl 4):56–63

    PubMed  Google Scholar 

  23. Sychterz CJ, Engh CA Jr, Shah N, Engh CA Sr (1997). Radiographic evaluation of penetration by the femoral head into the polyethylene liner over time. J Bone Joint Surg Am 79A:1040–1046

    Google Scholar 

  24. Sychterz CJ, Yang AM, McAuley JP, Engh CA (1999) Two-dimensional versus three-dimensional radiographic measurements of polyethylene wear. Clin Orthop 365:117–123

    Article  PubMed  Google Scholar 

  25. Sychterz CJ, Young AM, Engh CA (2001) Effect of radiographic quality on computer-assisted head penetration measurements. Clin Orthop 386:150–158

    Article  PubMed  Google Scholar 

  26. Thanner J, Kärrholm J, Herberts P, Malchau H (1999) Poor outcome of the PCA and Harris-Galante hip prostheses. Randomized study of 171 arthroplasties with 9-year follow-up. Acta Orthop Scand 70:155–162

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. From the School of Medicine, Universidad Autónoma de Madrid, Orthopaedic Department, Hospital La Paz, Madrid, Spain

    E. Garcia-Rey & E. Garcia-Cimbrelo

  2. Foundation Alcorcón, Alcorcón, Madrid, Spain

    E. Garcia-Rey

  3. Orthopaedic Department, Hospital La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain

    E. Garcia-Cimbrelo

  4. Costa Brava 5, p.1, 2°D, 28034, Madrid, Spain

    E. Garcia-Rey

Authors
  1. E. Garcia-Rey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Garcia-Cimbrelo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Garcia-Rey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Garcia-Rey, E., Garcia-Cimbrelo, E. Long-term results of uncemented acetabular cups with an ACS polyethylene liner. A 14–16-year follow-up study. International Orthopaedics (SICOT) 31, 205–210 (2007). https://doi.org/10.1007/s00264-006-0151-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-006-0151-6

Keywords

Search

Navigation