Saturday February 24, 1996

First generation prosthesis improves hip arthroplasty

A new study has found that using a first generation cementless hip prosthesis improves the success rate of primary hip arthroplasty.

The study presented Friday in poster exhibit B-18, reported progress of 91 patients over a 10-year period who received a porous-coated anatomic prosthesis for primary hip arthroplasty.

More than 92 percent of the patients who filled out the Harris Hip scale (a 100-point scale that measures function and pain in the hip) responded that they were satisfied with the results of the surgery, reported co-author John J. Callaghan, MD, professor of orthopaedic surgery, department of orthopaedic surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Seventy percent of the patients received an average Harris Hip rating of 81 points.

Additional findings by Dr. Callaghan and his colleagues revealed that osteolysis was present in 53 percent of the patients with the first generation cementless hip prosthesis. Bone loss in the femoral stem occurred in 39 percent of the patients; around the acetabular cup in 4 percent; and around both components in 10 percent.

Only six patients required revision surgery throughout the 10-year period. Three categories were identified by the orthopaedic surgeons as causes for the revision surgery. These were failure of ingrowth (two stems); aggressive osteolysis without loosening (two cups and one stem); aggressive osteolysis with loosening (two cups and one stem); and failure of the polyethylene liner (one cup).

Co-authors of the study with Dr. Callaghan are John S. Xenos, MD, R. David Heekin, MD, and Milan S. Moore, MD-all from the department of orthopaedic surgery service, Walter Reed Army Medical Center, Washington, D.C.; Carlton G. Savory, MD, The Hughston Clinic, Columbus, Ga.; and William J. Hopkinson, MD, Loyola University Medical Center, Maywood, Ill.

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