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Saturday, March 3, 2001

Likely durability of hybrid THA is 15 years

Femoral component fixation with cement remains the gold standard in total hip arthroplasty, researchers said Thursday in scientific paper 108. However, they observe that the long-term durability of stems with rough finishes has been questioned.

Their concludes "at up to 15 years follow-up, hybrid total hip arthroplasty offers excellent clinical function and survivorship. The roughened and precoated femoral component demonstrated excellent fixation; however, once loose, significant osteolysis and pain developed. The low loosening rate of this roughened and precoated stem must be balanced with the osteolysis and pain that develops if the stem does become loose."

The study involves 150 consecutive hybrid total hip arthroplasties performed using a cementless acetabular component and a cemented femoral component with a roughened (Ra = 60-80) and precoated surface finish. The mean age at arthroplasty was 67 years (range: 39 to 85 years). The average follow-up was 12 years (range: 10 to 15 years). Patients were prospectively followed clinically and radiographically.

The average preoperative HHS of 47 points increased to 86 points at follow-up. Aseptic loosening occurred in three femoral components, all were revised for secondary osteolysis and pain. All three stems had suboptimal, C-2 or D, cement mantles (p < 0.05). Three acetabular components developed loosening; one was revised while two remain asymptomatic. In addition, periarticular osteolysis was seen in three stable femoral components (2.0 percent) and two stable acetabular components (1.3 percent).

Using revision or loosening as the end point, the probability of both components surviving 15 years was 91.3 percent; 95.0 percent for the acetabular component; and 96.0 percent for the femoral component.

The researchers are Richard A. Berger, MD; Edward M. Nelson-Fruend, MD; Laura R. Quigley MS; Mitchell B. Sheinkop, MD; Joshua J. Jacobs, MD; Aaron G. Rosenberg, MD; and Jorge O. Galante, MD, all of Chicago, Ill.

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2001 Academy News March 3 Index C

Last modified 16/February/2001 by IS