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THE UNCEMENTED BI-CONTACT HIP ARTHROPLASTY – LONG-TERM RESULTS



Abstract

Introduction/Background: Uncemented total hip arthrolpasty [THA] was developed to achieve biological fixation of the prosthesis through integration of components into the prepared bone, especially in young patients with higher functional demands and longer life expectancy. The aim of this study was to update the results of a prospectiv series of primary cementless total hip arthroplasties after a minimum of 10 years follow-up

Materials and Methods: We reviewed 201 consecutive uncemented Bi-contact [Aesculap, Tuttlingen, Germany] THA in 177 patients. Harris hip score was recorded pre-operatively and at most recent follow up. Radiological measurements of the acetabulum for migration and radiolucency with Charnley-Lee zones, femur for stem subsistence, calcar resorption, prosthesis-bone radiolucency in the Gruen zones and hypertrophic calcification were carried out. Using revision as an end point, the cumulative survival of the prosthesis was noted. Survival analysis was performed using Kaplan-Meier curves and constructing life tables.

Results: 122 THR with a mean follow-up of 12.9 years were available for follow-up. 62 patients were dead and 17 patients were lost for follow-up. The mean age at surgery was 66.6 years (range 39–88).12 acetabula and 1 femur were revised in 11 patients due to any cause and 3 patients had indications for revision. The cumulative survival of the prosthesis with revision due to any cause was 95.42% at 10 years and 93.57% at 12 years. With revision due to aseptic loosening as an end-point, the cumulative survival was 97.8% at 10 years and 95.9% at 12 years. Comparison of worst-case curves using Log-rank test was statistically significant (p=0.0005).

Conclusion: Our series shows excellent stem results (without HA coating) with no revisions due to aseptic loosening. All stems were stable. Cup survivals were comparable to the other uncemented THA and cemented THA.


Correspondence should be sent to: Mr Girish Swamy, Derbyshire Royal Infirmary, Trauma and Orthopaedics, DE1 2QY Derby, United Kingdom, girishjam@yahoo.com

The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.