Abstract
This is a report of local experience with an elastic acetabular titanium cup, hydroxy-apatite coated. The cup was developed 14 years ago in France, where 4000 THRs are done annually and where more than one series reports a 98.9% survival rate at 10 years.
From February 2001 to December 2003, 486 cups were implanted in 466 patients, 222 female and 244 male, in 379 primary and 107 revision procedures. Mostly we used HDP cups cross-linked by the South African Gammalink method but we also used 169 Alumina sandwich-type inserts (Ceramtec, Germany). There were 158 uncemented modular hydroxy-apatite Esop stems and 265 cemented stems. The mean age of patients in whom the uncemented cup and stem combination was used was 47.8 years. The mean age of the other patients was 60.8 years. The uncemented modular stems were used in younger patients because this design is intended to give proximal stress transfer and prevent anterior thigh pain. UCLA activity scores of the younger patients compared favourably with those of patients with other implants.
Reoperation was necessary because of loose uncemented femoral stems, broken Alumina cups, recurrent dislocation in the absence of the functional abductor apparatus in revision surgery, and sepsis in two-stage revisions.
Because of the ease of insertion and excellent results, in the author’s practice this press-fit cup has all but replaced cemented cups in primary THR. In revision THR, supporting rings are used only where bone stock is inadequate for this type of implant.
Secretary: Dr H.J.S. Colyn, Editor: Professor M.B.E. Sweet. Correspondence should be addressed to SAOA, Box 47363, Parklands, Johannesburg, 2121, South Africa.
