Introduction: The purpose of this study was to report on the minimal 10-year followup results of a prospective randomized and a historical series of low friction cemented hip arthroplasties according to the surface finish of the femoral implant.

Patients and Methods: The prospective randomized series included 284 patients (310 hips) with a mean age of 64.1 years. Among these 310 hips, the femoral component had a highly polished surface (Ra = 0.04 micron, MKIII, Stryker) in 165 hips, and a matte surface finish (Ra = 1.7 microns, CMK3, Vector Orthopedique) in the remaining 145 hips. The historical series that was operated by the sames surgeons according to the same surgical technique included 111 patients (123 hips) with a satin finish femoral component (Ra = 0.9 micron, CMK2, Sanortho). Clinical results were rated according to the Merle d’Aubigne hip score. Radiologic analysis was performed according to the criteria of Barrack et al. for the definition of loosening. Moreover, a survival analysis according to the actuarial method was conducted.

Results: At the minimum 10-year follow-up evaluation, 43 patients (48 hips) were lost to follow-up (0.3 to 8.7 years), 80 patients (83 hips) were deceased (0.1 to 13.6 years), 26 patients had revision of either or both components (0.9 to 15.9 years), and 246 patients (276 hips) were alive and had not been revised after a mean 12.3 ± 1.9 years (10 to 16 years). Radiologic loosening of the femoral component, including revision, occured in one, four, and 15 hips for the polished, stain, and matte groups, respectively. The survival rate at 13 years of the femoral component, using loosening as the end point, was 97.3 ± 2.6% (95% CI, 92.2 to 100%), 97.1 ± 2.1% (95% CI, 93 to 100%), and 78.9 ± 5.8% (95% CI, 67.6 to 90.3%) for polished, satin, and matte stems, respectively.

Discussion: This study demonstrated that cement fixation of a femoral component was more reliable in the long term with a polished or satin surface finish. Based upon our results and the review of the literature, we recommend abondoning the use of cemented stems with a surface roughness greater than 1 micron.

Background: The Rangeuil orthopaedics surgical team has developed a special installation using a rigid corset for the combine Kocher Languenbeck and ilioinguinal surgical treatment of complex acetabular fractures. The purpose of this study was to retrospectively evaluate the results of 53 complex acetabular fractures treated by open reduction and internal fixation with a combined double approach facilitated by this particular operative installation.

Methods: A retrospective review of the cases was performed. The functional outcome, operative times, blood loss were recorded. Pre-operative, post-operative and last follow-up radiographs were assessed for fracture classification and adequacy of reduction. The development of heterotopic ossification, the presence of infection, avascular necrosis and post-traumatic osteoarthritis were also noted.

Results: The mean follow-up was 5.2 years. The clinical outcome at the time of final follow-up was graded as excellent in 16 patients, good in 22, fair in 7 and poor in 8 The reduction of the fracture, as determined with plain radiography, was graded as anatomic in 32 patients, unperfect in 15 and unsatisfactory in 6. Bony union was achieved in all cases. 6 patients had Brooker 3 or 4 heterotopic ossifications. 9 patients developed osteoarthritis. 4 patients developed avascular necrosis. An arthroplasty was necessary for 10 patients. 3 patients had a delayed wound infection.

Conclusions: The combined simultaneous approach remains a reliable surgical solution in selected complex acetabular fractures. The installation using the corset we developed considerably simplifies the operation and access to the operated site.