Twenty-three-Year Outcome of the Porous Coated Anatomic Total Hip Replacement

Abstract

We previously reported the ten to fourteen-year results for 311 Porous Coated Anatomic total hip replacements that had been inserted by two surgeons in 279 patients. The purpose of the present report is to update that study and to report the outcome beyond twenty years. The patients were followed prospectively with clinical assessment with use of the Harris hip score and radiographic analysis, and the results were collected in a database. Two hundred and sixty-eight hips were functioning at the time of death or at the time of the latest follow-up. A total of forty-three hips (14%) underwent major revision for all causes, and an additional four hips underwent minor revision. At a mean of twenty-three years of follow-up, Kaplan-Meier analysis revealed a survival rate of 83% with revision for any reason as the end point. The survival rate was 95% for the femoral component and 88% for the acetabular component with revision for any reason as the end point. The rate of survival of the acetabular component was significantly higher in hips with a 26-mm femoral head than in those with a 32-mm femoral head (91% compared with 80%; p = 0.026).

Ceramics and ceramic coatings in orthopaedics

“…This success provided incentives to other researchers to apply hydroxyapatite coatings onto femoral stems and cups in total hip arthroplasty. Clinical trials of coated hip stems were initiated by the mid-1980s [48], with follow-up on a number of these studies now exceeding 20 years [49][50][51][52]. Today HAp is the most used non-structural ceramic in joint arthroplasty [53].…”

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

“…There are a variety of uncemented stems that have been associated with excellent mid-term clinical and radiographic outcomes, whereas others showed disappointing results [25,30]. 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].…”

“…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.…”

The Outcome of 241 Charnley Total Hip Arthroplasties Performed by One Surgeon 30 to 40Years Ago

“…As more biological types of treatment for the commonest hip disease, osteoarthritis, are not yet in clinical practice, THA will remain the best treatment available [17]. Nonetheless, Recently, the 20 to 25 years results of uncemented prostheses have been reported [18][19][20][21][22][23][24][25][26][27], but the 30 years results of this technique or hybrid type techniques still remain unknown. Only the Charnley LFA with cement has a longer follow-up, with reported series with a minimum 25 [28,29], and 30 [3][4][5] years (Table 4) results.…”