Cement-Free Hip Replacement Has Good Long-Term Results

Twenty-year follow-up shows 96 percent of metal shells still going strong

18 may 2009-- Porous-coated acetabular metal shells inserted without the use of cement during total hip arthroplasty produce good long-term results, according to a study published in the May issue of the Journal of Bone & Joint Surgery.

Craig J. Della Valle, M.D., and colleagues at Rush University Medical Center in Chicago, conducted a follow-up of 114 (92 percent) out of 124 hips which had retained their original acetabular metal shell.

In all, there were five acetabular components which underwent revision for aseptic loosening or had radiographic evidence of loosening, and the modular acetabular liner on 14 hips with well-fixed acetabular shells had been changed due to excessive wear or as a function of treatment for osteolysis, the investigators found. A further eight hips had been recommended for liner changes, the researchers note.

"This cementless acetabular component provides durable fixation of the shell in primary total hip arthroplasty with survivorship of 99 percent at 10 years, 99 percent at 15 years, and 96 percent at 20 years postoperatively," the authors write. "No patient in this series who was older than 60 years at the time of the index arthroplasty has required a liner change (or had one recommended), and osteolysis as seen on plain radiographs has not been identified in any patient who was older than 65 years of age at the time of the index arthroplasty."

Financial disclosures were made in affiliation with Zimmer.

Abstract
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