Long-term results of total hip arthroplasty with an extensively porous coated stem in patients younger than 45 years old

Abstract

Purpose: This study analyzed the long-term results of cementless total hip arthroplasty using an extensively porous coated stem in patients younger than 45 years old.

Materials and methods: The clinical and radiographic results of 45 hips from 38 patients who underwent cementless total hip replacement arthroplasty with an AML prosthesis were reviewed retrospectively. The average follow-up was 12 years (range, 10-15 years).

Results: The average Harris hip score at the time of final follow-up was 87.3 (range 77-94) points. Forty two hips (93.3%) showed excellent and good clinical results. Osteolysis occurred around the stem in 20 hips (44.4%) and around the cup in 26 hips (57.8%). Stress-mediated femoral resorption was observed in 33 hips (73.3%) at 10 years. There was no incidence of resorption progressing after 5 years postoperatively. There was no stem loosening. Five hips were revised for osteolysis, cup loosening and polyethylene wear.

Conclusion: The long term results of total hip arthroplasty using an extensively porous coated stem were acceptable, and there was no case involving the progression of proximal bone resorption.

Keywords: Cementless total hip arthroplasty; extensively porous coated; osteolysis; polyethylene wear.

Fig. 1

Radiography taken at postoperative 11 years shows osteolysis around cup with excessive polyethylene wear. Revision arthroplasty with an allograft was carried out for an osteolytic lesion.