Abstract
Purpose: We report the clinical and radiological outcome of revision of cemented hip arthroplasties using Hydroxyapatite ceramic (HAC) coated femoral and acetabular components.
Methods: 86-revision hip arthroplasties were performed in 82 patients with JRI Furlong HAC coated femoral and acetabular components. 2 surgeon series. The patients were followed for a mean 12.6 years (7–15). The femoral component was revised in all hips and the ace-tabular cup was revised in 62 hips (72%). Threaded cup used in 37 (59%) patients and press fit cups with screws in the rest. Acetabular bone grafting was performed in 24 (38%) hips. The clinical outcome was measured using Harris, Charnley, Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS). The quality of life was assessed using EuroQol EQ-5D.
Results: The mean age was 78.2 yrs. The mean time to revision was 96 months. None lost to follow up. 11 patients died. Dislocation was seen in 2 patients (1 recurrent). 2 hips were infected (1 re revision, 1 excision arthroplasty). Cup liner revised in 1 patient. The mean Harris and Oxford scores were 82 (59 96) and 24.4 (12–52) respectively. The Charnley score was 5.0 (3–6) for pain, 4.9 (3–6) for movement and 4.4 (3–6) for mobility. Migration of acetabular component was seen in 2 (4%) hips. Acetabular radiolucencies were present in 26 hips (41%) The mean linear polythene wear was 0.05mm/year. Mean stem subsidence was 1.6mm (0.30– 2.4mm). Radiolucencies were present around 21 (33%) stems. Stress shielding was seen in 40 of 56 stems. Calcar resorption was seen in 11 stems (16%). Bony ingrowth was seen in 76(89%) of stems. Ectopic calcification was seen in 12 (19%) hips. Of the 3 hips re- revised, 2 were for deep sepsis and 1 for recurrent dislocation. Mean EQ- 5D description scores and health thermometer scores were 0.69 (0.51–0.89) and 79 (54–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 95.1% (95% CI =2.7),96.3% (95% CI = 2.1) for acetabular and femoral components respectively. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 93% (95% CI= 2.3).
Conclusion: The results of this study support the continued use of this prosthesis and document the durability of the HAC coated components. Our study had fewer cases of loosening of the components and had a better survival than bipolar implants or cemented acetabular components
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
