18-YEAR FOLLOW-UP AFTER CEMENTLESS TOTAL HIP ARTHROPLASTY WITH SPONGY METAL STRUCTURED IMPLANTS

Abstract

Background: A total hip arthroplasty system with 3-dimensional interconnecting surface topography was developed for optimum osseous integration and long term stability. The present study was performed to assess long-term implant survival and function.

Methods: We prospectively studied a consecutive series of 100 cementless total hip arthroplasties in 94 patients using the ESKA GHE cementless spongy metal hip replacement. Study end-point was implant revision, and both function as well as satisfaction with treatment outcome was assessed after a mean follow-up of 18 years.

Results: Mean age at the time of operation was 47 years [range 18–65]. Seven patients were lost to follow-up. 11 patients had died for unrelated reasons at 14.1 ± 4.3 years after surgery with all 14 hip replacements in situ. Consequently, at a mean follow-up of 18 years [15.3 – 20.3], 74 patients (74 hips) could be included in the final analysis. Survival with aseptic loosening as the endpoint was 95% for the femoral component and 85% for the acetabular component. Two cups had to be revised for recurrent dislocation, resulting in a total implant survival at follow-up of 95% for the femoral component and 81% for the acetabular component.

Very good functional results were obtained with an improvement of the mean Merle d’Aubigné score from 9.5 ± 2.0 at baseline to 15.0 ± 3.1 at follow-up, and 86% excellent or good results (McNab score). Satisfaction with treatment outcome was high, and 96% of patients would recommend the performed procedure to a friend.

Conclusion: Excellent survival rates were observed in a young patient population after cementless hip arthroplasty with the GHE spongy metal hip replacement at a mean follow-up of eighteen years. Thus, modern cementless hip replacement shows long-term survival and might be favourable in young and active patients.