The Harris-Galante Cementless THA: A 19- to 25-Year Follow-Up Study

Saito, Shu; Ishii, Teruhisa; Mori, Sei; Hosaka, Kunihiro; Tokuhashi, Yasuaki

doi:10.3928/01477447-20101123-08

Cited by 16 publications

(15 citation statements)

References 15 publications

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“…However, there are few reports on the survival of uncemented stems with a minimum followup of 20 years or more [1,5,36,39]. Some uncemented stems with clinical followup into the third decade [1, 5, 13, 18, 35-37, 39, 40, 54] have undergone major design changes or are no longer available for clinical use [1,18,36,37,46]. In addition, there is little evidence on the factors influencing longterm survival of uncemented stems.…”

Section: Introductionmentioning

confidence: 99%

Long-term (20- to 25-year) Results of an Uncemented Tapered Titanium Femoral Component and Factors Affecting Survivorship

Streit¹,

Innmann²,

Merle³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Uncemented femoral components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the third decade. Questions/purposes We evaluated (1) survivorship using femoral revision for any reason as the end point; (2) survivorship using femoral revision for aseptic loosening as the end point; and (3) patient-related and surgical risk factors for aseptic stem loosening at a minimum 20-year followup with an uncemented tapered titanium stem.Methods We reviewed the clinical and radiographic results of 354 THAs in 326 patients performed between January 1985 and December 1989 using an uncemented grit-blasted, tapered titanium femoral stem. Mean age at surgery was 57 years (range, 13-81 years). Kaplan-Meier survivorship analysis was used to estimate long-term survival. Minimum followup evaluation was 20 years (mean, 22 years; range, 20-25 years); at that time, 120 patients (127 hips) had died, and four patients (five hips) were lost to followup. Multivariate survival analysis using a Cox regression model was performed. Results Survivorship at 22 years with revision of the femoral component for any reason as the end point was 86% (95% confidence interval [CI], 81%-90%). Survivorship for femoral revision for aseptic loosening as the end point was 93% at 22 years (95% CI, 90%-96%). Undersized stems (canal fill index B 80%) and stems in hips with cup revision were at higher risk for aseptic loosening (hazard ratio, 4.2 and 4.3, respectively). There was a high rate of acetabular revision in this series (38%), mostly related to smooth-threaded, cementless sockets. Conclusions Uncemented femoral fixation was reliable into the third decade. Age, male sex, and diagnosis were not associated with a higher risk of aseptic loosening.

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Section: Introductionmentioning

confidence: 99%

Long-term (20- to 25-year) Results of an Uncemented Tapered Titanium Femoral Component and Factors Affecting Survivorship

Streit¹,

Innmann²,

Merle³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The success of total hip arthroplasty (THA) over the last 40 years is widely reported (1-2-3-4-5-6-7-8-9-10) with cemented and cementless femoral stems having broadly reported similar results (11). Most studies however, report the results of treating primary osteoarthritis (3, 5-6, 8-9, 12-13), with few studies reporting the long-term outcome in managing avascular necrosis of the hip (AVN) (6-7, 10). AVN hip is the most common indications for THA in Hong Kong (12-13-14).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Result of Cementless Femoral Stem in Avascular Necrosis of the Hip

2014

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Avascular necrosis (AVN) of the hip may have extensive involvement of the proximal femur which may affect boney ingrowth into cementless femoral stems. From 1994 to 2004, 182 total hip arthroplasties (in 144 patients, 117 AVN hips and 65 non-AVN hips) were performed using hydroxyapatite coated femoral stems. All patients were followed up prospectively. Mean age was 51 years and mean follow-up 14.7 years (range 9.7-19.1 years). Four stems were revised because of aseptic loosening, 3 in AVN group and 1 in non-AVN group. The overall mechanical failure rate was 2.2%, the mechanical failure rate in AVN and non-AVN group was 2.6% and 1.5% respectively (p = 1). The 19.1 year survival using revision for aseptic loosening as an endpoint for AVN and non-AVN patients were 97.1% and 96.2% respectively (p = 0.654). Stable boney ingrowth was present in 99.5% hips. This study represents 1 of the largest series reporting the long-term follow-up of the use of cementless femoral stems in treating AVN of the hip. We report excellent long-term survival of cementless total hip arthroplasty used in managing AVN of the hip and is comparable to that seen in non-AVN total hip arthroplasty.

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“…It is quite possible that the relatively weaker bond at this interface (in contrast to the pre-cut grooves in a standard cemented component) was the main factor leading to this failure. The results at a mean of more than seven years, which compare favourably with those using alternative revision techniques, 22 and indeed with many primary series in a similar time frame, [23][24][25][26] are encouraging and support the continued use of this technique. Limitations of this study include the fact that, despite being prospective, it was an observational case series with relatively small numbers.…”

Section: Discussionmentioning

confidence: 69%

Revision total hip replacement using the cement-in-cement technique for the acetabular component

Brogan

Charity

Sheeraz

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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The technique of femoral cement-in-cement revision is well established, but there are no previous series reporting its use on the acetabular side at the time of revision total hip replacement. We describe the technique and report the outcome of 60 consecutive acetabular cement-in-cement revisions in 59 patients at a mean follow-up of 8.5 years (5 to 12). All had a radiologically and clinically well-fixed acetabular cement mantle at the time of revision. During the follow-up 29 patients died, but no hips were lost to follow-up. The two most common indications for acetabular revision were recurrent dislocation (46, 77%) and to complement femoral revision (12, 20%). Of the 60 hips, there were two cases of aseptic loosening of the acetabular component (3.3%) requiring re-revision. No other hip was clinically or radiologically loose (96.7%) at the latest follow-up. One hip was re-revised for infection, four for recurrent dislocation and one for disarticulation of a constrained component. At five years the Kaplan-Meier survival rate was 100% for aseptic loosening and 92.2% (95% CI 84.8 to 99.6), with revision for any cause as the endpoint. These results support the use of cement-in-cement revision on the acetabular side in appropriate cases. Theoretical advantages include preservation of bone stock, reduced operating time, reduced risk of complications and durable fixation.

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The Harris-Galante Cementless THA: A 19- to 25-Year Follow-Up Study

Cited by 16 publications

References 15 publications

Long-term (20- to 25-year) Results of an Uncemented Tapered Titanium Femoral Component and Factors Affecting Survivorship

Long-term (20- to 25-year) Results of an Uncemented Tapered Titanium Femoral Component and Factors Affecting Survivorship

Long-Term Result of Cementless Femoral Stem in Avascular Necrosis of the Hip

Revision total hip replacement using the cement-in-cement technique for the acetabular component

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