Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 1;6(5 Supple A):14-21.
doi: 10.1302/2633-1462.65.BJO-2024-0197.R1.

Cementless acetabular component without screw holes with immediate full weightbearing : a minimum 20-year follow-up study

Lawrence C M Lau  1 , Kin Y Wong  2 , Hongjian Hu  2 , Man H Cheung  1 , Fu Y Ng  1 , Henry Fu  1 , Ping K Chan  1 , Kwong Y Chiu  1
Affiliations

Cementless acetabular component without screw holes with immediate full weightbearing : a minimum 20-year follow-up study

Lawrence C M Lau et al. Bone Jt Open. .

Abstract

Aims: This study aimed to evaluate the survival of a cementless component without screw holes in total hip arthroplasty (THA) at a minimum follow-up of 20 years. This design has the benefits of maximizing bone contact and reducing osteolysis by eliminating channels to backside wear. However, transacetabular screws cannot be used.

Methods: A total of 71 hips in 58 patients receiving the same model of cementless component without screw holes (Depuy Duraloc 100 hydroxyapatite (HA) component) from June 1999 to March 2003 were prospectively followed up. All patients were allowed to have immediate full weightbearing. The mean age at THA was 53.7 years (28 to 74). Osteonecrosis was the leading cause of THA. Survival was assessed with any revision and component revision as the endpoint. Radiological parameters, including lateral opening angle, and the components' vertical and horizontal migration distances, were measured and compared between the early postoperative period and final follow-up.

Results: Overall, 54 hips were assessed at a minimum 20-year follow-up. The mean follow-up was 22.9 years (20.9 to 24.5). Two component revisions occurred at 17.5 and 17.6 years later. Both components were well fixed but were revised, due to the need to upsize the articulation and component malpositioning, respectively. Conventional polyethylene (PE) was used in both hips, and 14 other hips were revised with the components well fixed and not revised. The estimated survival of the acetabular component and THA at 20 years was 96.4% and 74.5%, respectively. Mean changes in lateral opening angle and vertical and horizontal migration distances were 0.48° (SD 1.45°), -0.06 mm (SD 1.44), and -0.36 mm (SD 1.36), respectively, with no statistical significance.

Conclusion: This study provides evidence of excellent long-term survival of cementless components without screw holes. Immediate postoperative weightbearing did not lead to component migration in the long term.

PubMed Disclaimer

Conflict of interest statement

K. Y. Chiu is a paid consultant for Depuy Synthes, Johnson & Johnson, Smith & Nephew, Stryker, Mako, Zimmer Biomet, and Microport, unrelated to this study.

Figures

Fig. 1
Fig. 1
This 56-year-old male patient's pre-revision pelvic radiograph (anteroposterior view) (left) showed stem loosening and polyethylene (PE) wear, but no acetabular component loosening. The one-month post-revision pelvic radiograph (anteroposterior view) (right) showed that the articulation had been upsized, and the original component was replaced by a larger component.
Fig. 2
Fig. 2
This 61-year-old male patient's pre-revision pelvic radiograph (anteroposterior view) (left) showed that there was polyethylene (PE) wear, and the component was of suboptimal positioning with a lateral opening angle of 70°. It was found to be well-fixed intraoperatively, and a column fracture had resulted during the removal process and required additional plate fixation. The one-month post-revision pelvic radiograph (anteroposterior view) (right) showed a new component with plate fixation.
Fig. 3
Fig. 3
The Kaplan-Meier (KM) curve for the time to component revision showed that the estimated survival probability was 96.4% at 20 years (95% CI 91.8 to 100).
Fig. 4
Fig. 4
The Kaplan-Meier (KM) curves for time to any hip revisions, component revisions, and stem revisions demonstrated that the majority of revisions resulted from stem revision.
Fig. 5
Fig. 5
The Kaplan-Meier (KM) curve for time to any hip revision showed that the estimated survival probability was 74.5% (95% CI 64.3 to 86.3) at 20 years.
Fig. 6
Fig. 6
The estimated cumulative incidence function for the time to hip revision based on the competing risk (CR) analysis and one minus the Kaplan-Meier (KM) curve for time to hip revision (with death treated as censoring).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kim YH, Park JW, Jang YS, Kim EJ. Minimum 30-year results of bilaterally implanted cemented and cementless total hip arthroplasty in patients younger than 50 years. J Arthroplasty. 2023;38(5):873–879. doi: 10.1016/j.arth.2022.11.003. - DOI - PubMed
    1. García-Rey E, Carbonell-Escobar R, Cordero-Ampuero J, García-Cimbrelo E. Outcome of a hemispherical porous-coated acetabular component with a proximally hydroxyapatite-coated anatomical femoral component: an update at 23 to 26 years’ follow-up. Bone Joint J. 2019;101-B(4):378–385. doi: 10.1302/0301-620X.101B4.BJJ-2018-1223.R1. - DOI - PubMed
    1. Ng FY, Zhu Y, Chiu KY. Cementless acetabular component inserted without screws - the effect of immediate weight-bearing. Int Orthop. 2007;31(3):293–296. doi: 10.1007/s00264-006-0189-5. - DOI - PMC - PubMed
    1. Schmalzried TP, Jasty M, Harris WH. Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg Am. 1992;74-A(6):849–863. - PubMed
    1. No authors listed 1st Annual Report. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2000. [28 February 2025]. https://aoanjrr.sahmri.com/documents/10180/75186/Annual+Report+2000.pdf/... date last. accessed.