Precoated femoral component in total hip arthroplasty. Results of 5- to 9-year followup.

Abstract

One hundred nineteen consecutive primary hybrid total hip arthroplasties with a precoated femoral component were performed by one surgeon in 100 patients and followed up prospectively. Ninety-eight hips in 82 patients (mean age, 67 years) were evaluated clinically and radiographically at a mean of 6.5 years (range, 5-9 years). The hips were evaluated clinically using the Harris hip score, and radiographs were evaluated for femoral cement grade, loosening, and osteolysis. Ninety-five hips remained in place at the most recent followup. Two femoral components were revised for definite loosening, and one well fixed femoral component was removed because of late hematogenous infection. Excluding the three hips that were revised, the clinical result was excellent or good in 79 hips (83%), fair in 12 hips (13%), and poor in four hips (4%). All other femoral components were well fixed. There were defects of the cement mantles (C1 and C2) in 90 hips. No femoral component had a stem and cement radiolucent line. Focal femoral osteolysis was seen in only two hips. One acetabular component was removed at 5 years because of late hematogenous infection. One acetabular component had asymptomatic migration. The remaining 96 acetabular components were well fixed. Focal acetabular osteolysis was present in four hips. The mean linear polyethylene wear rate was 0.06 (+/- 0.05) mm per year. In contrast to other reports of early failure and osteolysis, the use of a precoated femoral component in this study did not adversely affect the fixation of hybrid total hip arthroplasty, with definite failure of only 2% (two of 98) of the femoral components.