We report the results of seventy-six Harris Galante Porous Cups (HGP 1) in sixty-three patients treated by Total Hip Arthroplasty (THA) with a diagnosis of avascular necrosis (AVN) of the femur (grade III and IV). The cups were inserted between 1986 and 1994 and followed prospectively. Seventy hips with a follow up of more than five years (mean 7.6 years) were reviewed. At last review the mean Harris Hip Score was 94 (standard deviation (&
dcl001;) .8), preoperatively the mean had been 29 (&
dcl001;14.7). Radiographically there was no evidence of acetabular migration. The revision rate of the femoral prosthesis was 8.6%, however only three stems (4.3%) were revised for loosening the rest being revised to allow down sizing of the femoral head. The revision rate for the acetabular prosthesis was 7.1%, (five cups). At the time of revision none of the cups were clinically loose and only required the liner to be changed. The complication rate was low with no deep infections or dislocations and only nine hips, (11.8%) with grade III heterotopic ossification. Survival analysis for both stem and cup at 8 years is 96.3% (confidence interval 91 – 100%), with a worst-case survival of 93.6%, (C.I 87.4 – 99.9%) Previous studies of patients undergoing cemented THA for the treatment of advanced AVN have reported a high incidence of component loosening. This study shows good medium term results using the Harris Galante Porous cup for acetabular reconstruction with cemented femoral components for the treatment of this difficult problem.
We describe the results of 76 total arthroplasties of the hip for stage-III or stage-IV avascular necrosis of the femoral head. Harris Galante Porous cups were used in 63 patients between 1986 and 1994 and followed prospectively. We reviewed 70 hips with a follow-up of more than five years (mean 7.6). At the latest review the mean Harris Hip Score had improved from a preoperative value of 29 ± 14.7 to 94 ± 6.8. Radiologically, there was no evidence of acetabular migration. The rate of revision for the femoral component was 8.6%, three being undertaken for loosening and three to allow downsizing of the femoral head. The rate of revision for the acetabular component was 7.1% (five cups). At the time of revision none of the cups was clinically loose, and only required the liner to be changed. The rate of complications was low with no case of deep infection or dislocation, but nine of the 76 hips (11.8%) showed grade-III heterotopic ossification. Previous studies of patients undergoing cemented total hip arthroplasty for the treatment of advanced avascular necrosis have indicated a high incidence of loosening of the acetabular component. Our findings show good medium-term results using the Harris Galante Porous cup for acetabular reconstruction, together with a variety of cemented femoral components, for the treatment of this difficult problem.