THE FATE OF CEMENTLESS ACETABULAR COMPONENTS RETAINED DURING REVISION OF A FEMORAL COMPONENT OF A TOTAL HIP ARTHROPLASTY.

Abstract

Eighty-three patients (ninety hips) with well-fixed cementless socket retained during revision of a femoral component were reviewed. At revision, 33% of patients had acetabular osteolysis and 52% were grafted. At mean follow-up 9.6 years (5.5 – 15.9) after femoral revision and 14.8 years (7.1–20.2) after primary arthroplasty, survivorship was 96.5% (95% CI, 91.5% to 100%) at five years and 81%(95% CI, 61% to 99%) at ten years after femoral revision. Revision of a cementless acetabular component solely on the basis of the duration that it was in vivo or whether a previous revision had been done does not appear to be warranted.

Removal a well fixed cementless acetabular component can result in an increased operative morbidity. Data that can be used to predict the long-term survival of retained well-fixed cementless acetabular components are therefore needed.

Retention of the well-fixed cementless acetabular component during femoral revision is a predictable technique.

Revision of a cementless acetabular component solely on the basis of the duration that it was in vivo or whether a previous revision had been done does not appear to be warranted.

Eighty-three consecutive patients (ninety hips) in whom a well-fixed cementless socket had been retained during revision of a femoral component were reviewed. Mean patient age was fifty-four. At the time of revision, 33% of the patients had acetabular osteolysis of which 52% were grafted. At a mean follow-up 9.6 years (5.5 – 15.9) after femoral revision and 14.8 years (7.1–20.2) after primary arthroplasty, 94.5% of the sockets remained in place. With any revision as end point, survivorship was 96.5%(95% CI, 91.5% to 100%) at five years and 81%(95% CI, 61% to 99%) at ten years after femoral revision. With failure of cementless socket as end point (i.e. loosening, deficient locking mechanism), survivorship was 100% (95% CI, 100%) and 94% (95% CI, 82%–100%) at five and ten years after femoral revision and 100% (95% CI, 100%) and 94% (95% CI, 82%–100%) at ten and fifteen years after primary arthroplasty. No cases showed recurrence or expansion of pelvic osteolysis. The overall incidence of dislocation was 15%.