Abstract
We report the long-term radiographic results of the total hip arthroplasty with use of the cementless porous coated Harris-Galante (H-G) stem. Seventy-five consecutive patients, eighty-eight hips formed the basis of this study. Fifty patients were male, twenty-five patients were female, and thirteen patients were bilateral. The mean age of patients at operation was 42 years. They were followed up for an average of thirteen years four months (ten years two months to fourteen years four months). The diagnosis was avascular necrosis of the femoral head in 49 cases, degenerative osteoarthritis in 32 cases. Clinical results were estimated by modified Harris hip score and thigh pain, and radiographic results by periodically checked plain X-ray film. The average Harris hip score increased from 60 points preoperatively to 83 points at the most recent follow-up examination. The hip pain score increased from 31 points to 41 points. Clinically severe thigh pain was observed in 3 cases (4%). In radiographic evaluation, subsidence more than 5mm was seen in 2 cases (2%). Periprosthetic osteolytic lesion was observed in 15 cases (17%), but the lesions do not influence stability of the stem. Femoral stem stability by Engh was stable in 72 cases, fibrous stable in 12 cases, unstable in 4 cases. Pedestal formation, cortical hypertrophy of the distal femur, and stress shielding was observed more than 40%. Subcollar resorption was identified in 29% and ectopic ossification in 15%. Revision of the femoral stem was needed in 4 cases for aseptic loosening. At 10 years probability of survival of the stem using Kaplan-Meyer method was 95.5%. Use of the cementless H-G stem yielded the excellent long-term outcome, but osteolysis and stress shielding would be the main problems to solve.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
