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REVISION OF CEMENTED HIP ARTHROPLASTY USING HAC COATED ENDOPROSTHESIS- A SEVEN TO 15-YEAR FOLLOW-UP



Abstract

Introduction and Aims: We report the clinical/radiological outcome of revision of cemented hip arthroplasties using Hydroxyapatite ceramic (HAC) coated femoral and acetabular components

Method: Sixty revision hip arthroplasties were performed in 64 patients with JRI Furlong HAC coated femoral and acetabular components. Mean follow-up was 10 years. Clinical outcome was measured using Harris, Charnley and Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS) and quality of life using EuroQol EQ-5D.

Results: The mean age was 78 years. The mean time to revision was 96 months. Eleven died to causes unrelated to index revision. Mean Harris and Oxford scores were 82 and 24.4. The Charnley score was 5.0 for pain, 4.9 for movement and 4.4 for mobility. Migration > 4mm of the acetabular component was seen in two hips. Acetabular radiolucencies were present in 26 hips. Mean linear polythene wear was 0.05mm/year. The mean subsidence was 1.6mm. Radiolucencies were present around 21 stems. Stress shielding was seen in 40; calcar resorption in 11; and endosteal cavitation around two stems. Ectopic calcification was seen in 12 hips. Three hips were re-revised – two for deep sepsis, one for recurrent dislocation. Mean EQ- 5D description and health scores were 0.69 and 79 (p> 0.05). With failure defined as repeat revision because of aseptic loosening, the rate of survival at 12 years was 100% for acetabular and femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 93% (95% CI ± 2.3).

Conclusion: The results of this study support the continued use of this prosthesis and document the durability of the HAC coated components, with fewer cases of loosening of the components, and a better survival than bipolar implants or cemented acetabular components. As loosening can occur as a late phenomenon, a longer follow-up is needed to determine the longevity of the HAC coated prosthesis.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors is receiving any financial benefit or support from any source.