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Long-term survival of the uncemented Balgrist total hip replacement cup

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Abstract

Purpose

The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of the Balgrist total hip replacement cup.

Methods

We report the results of a retrospective review of 195 total hip prostheses with Balgrist cup implanted in 178 patients. There were 59 men and 119 women with a mean age at surgery of 52.3 years (range, 19–72). Cox regression was used to determine the influence of independent variables on the survivorship of the prosthesis.

Results

There were 117 (66 %) of 178 patients, and 131 (67 %) of 195 hips available for assessment at a mean follow-up of 17.4 years. A total of 21 patients (22 hips) were lost from follow-up (12 %). A total of 25 patients (27 hips) required some type of re-operation during the follow-up period. Eight of 27 re-operations (30 %) were directly caused by the Balgrist cup failure due to fatigue fracture of the metallic shell (n = 5; 19 %), polyethylene wear (n = 2; 7 %) and aseptic loosening (n = 1; 4 %). The mean polyethylene wear rate was 0.068 mm/year (range, 0.008–0.230; SD = 0.043). The risk of re-operation for any reason was decreased with dysplastic hip as a primary diagnosis (hazard ratio; HR = 0.250; 95 % CI 0.086–0.725) and with greater age at the time of surgery (HR = 0.923; 95 % CI 0.880–0.969). The 19-year survivorship with re-operation for any reason was 75.6 % (95 % CI 67.0–84.2). The 19-year survivorship with re-operation for the Balgrist cup failure was 90.5 % (95 % CI 83.4–97.6).

Conclusions

The Balgrist cup continues to provide excellent clinical and radiological outcomes. This is associated at least in part with a low polyethylene wear rate. The main reason for the Balgrist cup failure is fatigue fracture of the metallic shell.

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Acknowledgments

The work on the study was supported by IGA Ministry of Health Czech Republic (IGA MZ CR NT/11049 and NT/14267). The authors thank Prof. Stuart B. Goodman from the Stanford Medical School for critical reading of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, 77520, Olomouc, Czech Republic

    Jiri Gallo & Jiri Lostak

  2. Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University, Hněvotínská 3, 775 15, Olomouc, Czech Republic

    Katerina Langova

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  1. Jiri Gallo
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Correspondence to Jiri Gallo.

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Gallo, J., Lostak, J. & Langova, K. Long-term survival of the uncemented Balgrist total hip replacement cup. International Orthopaedics (SICOT) 37, 1449–1456 (2013). https://doi.org/10.1007/s00264-013-1946-x

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