PAPER 075: MINIMUM 10-YEAR FOLLOW-UP OF A SECOND GENERATION FULLY COATED FEMORAL COMPONENT IN PRIMARY THR

Abstract

Purpose: The original AML prosthesis was fully coated and later the manufacturer switched it to 5/8ths coating. The second generation Prodigy femoral component was developed to return to full coating of the prosthesis and to provide a medial relief to decrease bone stress shielding. The purpose of this study was to evaluate the minimum ten year results using this device and to compare the results to the same surgeon’s results at 10 years using a first generation proximally coated device.

Method: 100 consecutive primary total hip replacements were performed by a single surgeon in 86 patients using the Prodigy (DePuy, Warsaw, Indiana) femoral component between 1994 and 1997. The components were mated with 80 HGI and 20 Duraloc acetabular components. Patients were evaluated with WOMAC ratings, need for revision and radiographic loosening. The same parameters had been evaluated at minimum 10-year follow-up for the same surgeon’s initial 100 consecutive PCA (Stryker, New Jersey) primary THR’s and were compared to the present series.

Results: At minimum 10 year follow-up, 71 patients with 83 hips were living. The average clinical follow-up for the living patients was 11 years (range 10 to 12 years) and the average radiographic follow-up was 9.2 years for this group (range 7–12 years). No femoral component was revised for loosening and all femoral components were bone ingrown on radiographs. 7 acetabular components required a liner exchange or revision for polyethylene wear. This compares favorably to the same surgeon’s 10 year results with the PCA where 6 femoral components were revised for wear or loosening and an additional 2 were radiographically loose.

Conclusion: The Prodigy femoral component demonstrated excellent durability at 10 years. With the newer cementless stems with a wide variety of sizes, femoral loosening is rarely a clinical problem.