Outcome of Total Hip Arthroplasty Using Extensively Porous-Coated Components at 20-Year Follow-Up

Abstract

Porous-coated total hip arthroplasty (THA) components were introduced with the hope that they would achieve durable biologic fixation. Between October 1982 and December 1984, we performed 223 THAs among 215 patients using the Anatomic Medullary Locking stem and TriSpike cup (DePuy). The mean age at surgery in this consecutive, unselected series was 55 ± 15 years (range, 16-87 years). Ninety-one patients (93 THAs) with less than 20-year follow-up are now deceased. The mean follow-up for the 130 remaining THAs is 21.1 ± 2.4 years. Forty-seven THAs have required component revisions. In 22 cases, the first revision was limited to a liner exchange for polyethylene wear or osteolysis. Three stems have been revised for aseptic loosening. Owing to the high incidence of wear-related revisions, Kaplan-Meier survivorship at 20-year follow-up, using component revision for any reason as an end point, was 75 ± 7% (95% confidence intervals). In contrast, survivorship using stem revision for any reason as an end point was 98 ± 2% at 20-year follow-up. Survivorship of the porous-coated shell, using cup revision for any reason as an end point, was 86 ± 5% at 20 years. Despite revisions for wear-related complications in this relatively young patient population, the fixation achieved with these extensively porous-coated components remained durable through 20-year follow-up.