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The Bone & Joint Journal
Vol. 96-B, Issue 12 | Pages 1674 - 1680
1 Dec 2014
Choi WJ Lee JS Lee M Park JH Lee JW

We compared the clinical and radiographic results of total ankle replacement (TAR) performed in non-diabetic and diabetic patients. We identified 173 patients who underwent unilateral TAR between 2004 and 2011 with a minimum of two years’ follow-up. There were 88 male (50.9%) and 85 female (49.1%) patients with a mean age of 66 years (. sd. 7.9, 43 to 84). There were 43 diabetic patients, including 25 with controlled diabetes and 18 with uncontrolled diabetes, and 130 non-diabetic patients. The clinical data which were analysed included the Ankle Osteoarthritis Scale (AOS) and the American Orthopaedic Foot and Ankle Society (AOFAS) scores, as well the incidence of peri-operative complications. The mean AOS and AOFAS scores were significantly better in the non-diabetic group (p = 0.018 and p = 0.038, respectively). In all, nine TARs (21%) in the diabetic group had clinical failure at a mean follow-up of five years (24 to 109), which was significantly higher than the rate of failure of 15 (11.6%) in the non-diabetic group (p = 0.004). The uncontrolled diabetic subgroup had a significantly poorer outcome than the non-diabetic group (p = 0.02), and a higher rate of delayed wound healing. . The incidence of early-onset osteolysis was higher in the diabetic group than in the non-diabetic group (p = 0.02). These results suggest that diabetes mellitus, especially with poor glycaemic control, negatively affects the short- to mid-term outcome after TAR. Cite this article: Bone Joint J 2014;96-B:1674–80


The Bone & Joint Journal
Vol. 103-B, Issue 11 | Pages 1648 - 1655
1 Nov 2021
Jeong S Hwang K Oh C Kim J Sohn OJ Kim JW Cho Y Park KC

Aims

The incidence of atypical femoral fractures (AFFs) continues to increase. However, there are currently few long-term studies on the complications of AFFs and factors affecting them. Therefore, we attempted to investigate the outcomes, complications, and risk factors for complication through mid-term follow-up of more than three years.

Methods

From January 2003 to January 2016, 305 patients who underwent surgery for AFFs at six hospitals were enrolled. After exclusion, a total of 147 patients were included with a mean age of 71.6 years (48 to 89) and 146 of whom were female. We retrospectively evaluated medical records, and reviewed radiographs to investigate the fracture site, femur bowing angle, presence of delayed union or nonunion, contralateral AFFs, and peri-implant fracture. A statistical analysis was performed to identify the significance of associated factors.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_I | Pages 31 - 31
1 Mar 2002
Kempf J Prues-Labour V Bonnomet F Lefalne Y Schlemmer B
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Purpose: There is still debate on classification, pathogenesis, and treatment of partial non-full thickness tears of the rotator cuff. We assessed mid-term outcome after arthroscopic repair. Material and methods: Between 1990 and 1998, 208 partial tears of the rotator cuffs were treated in our unit. Eighty patients were reviewed by an examiner different and independent from the surgery team. The review included a physical examination, Constant score and radiography. The series included 42 men and 38 women, mean age 52 years (23–73) who were seen at a mean follow-up of 59 months (17–118). We identified four groups: group 1 included lesions of the deep articular aspect of the supraspinatus: 34 cases; group 2 included tears of the superficial aspect: 27 cases; group 3 included tears involving both the deep and superficial aspect without full-thickness tear on the preoperative arthrogram; and group 4 included lesions involving a partial tear of the supraspinatus associated with another articular lesion. Acromioplasty was performed in all cases associated with section of the acromiocoracoid ligament. Results: Absolute Constant score progressed from 53 points preoperatively to 80 points at last follow-up. Mean Constant score of the contralateral shoulder was 87 points. There was a significant difference between outcome in the first three groups where the mean age was 50 years and the fourth group (trauma context) where the mean age was 36 years. Constant score was 84.7, 92, 92, and 73 for groups 1, 2, 3 and 4 respectively. There was no statistically significant improvement compared with the preoperative Constant score (67 points). Radiographically, there was no change in the subacromial space. Superficial lesions were more frequently associated with type 3 acromial impingement. Discussion: Globally, we observed a deterioration of outcome with time compared with the first review, with 76% satisfactory results at five years. The same outcome was obtained with superficial and deep lesions. We are in agreement with others that it is necessary to identify a subgroup of patients under 40 years of age with a partial tear of the rotator cuff in a trauma context. For these patients, arthroscopic acromioplasty is not a satisfactory therapeutic approach. The causal lesion (posterosuperior impingement, rim injury or instability) should be treated


The Bone & Joint Journal
Vol. 102-B, Issue 12 | Pages 1697 - 1702
1 Dec 2020
Schormans PMJ Kooijman MA Ten Bosch JA Poeze M Hannemann PFW

Aims

Fixation of scaphoid nonunion with a volar locking plate and cancellous bone grafting has been shown to be a successful technique in small series. Few mid- or long-term follow-up studies have been reported. The aim of this study was to report the mid-term radiological and functional outcome of plate fixation for scaphoid nonunion.

Methods

Patients with a scaphoid nonunion were prospectively enrolled and treated with open reduction using a volar approach, debridement of the nonunion, and fixation using a locking plate and cancellous bone grafting, from the ipsilateral iliac crest. Follow-up included examination, functional assessment using the patient-rated wrist/hand evaluation (PRWHE), and multiplanar reformation CT scans at three-month intervals until union was confirmed.


The Bone & Joint Journal
Vol. 103-B, Issue 11 | Pages 1646 - 1647
1 Nov 2021
Jeong S Hwang K Oh C Kim J Sohn OJ Kim JW Cho Y Park KC


The Bone & Joint Journal
Vol. 102-B, Issue 8 | Pages 1082 - 1087
1 Aug 2020
Yiğit Ş Arslan H Akar MS Şahin MA

Aims

Osteopetrosis (OP) is a rare hereditary disease that causes reduced bone resorption and increased bone density as a result of osteoclastic function defect. Our aim is to review the difficulties, mid-term follow-up results, and literature encountered during the treatment of OP.

Methods

This is a retrospective and observational study containing data from nine patients with a mean age of 14.1 years (9 to 25; three female, six male) with OP who were treated in our hospital between April 2008 and October 2018 with 20 surgical procedures due to 17 different fractures. Patient data included age, sex, operating time, length of stay, genetic type of the disease, previous surgery, fractures, complications, and comorbidity.


The Bone & Joint Journal
Vol. 99-B, Issue 9 | Pages 1197 - 1203
1 Sep 2017
Laumonerie P Reina N Ancelin D Delclaux S Tibbo ME Bonnevialle N Mansat P

Aims

Radial head arthroplasty (RHA) may be used in the treatment of non-reconstructable radial head fractures. The aim of this study was to evaluate the mid-term clinical and radiographic results of RHA.

Patients and Methods

Between 2002 and 2014, 77 RHAs were implanted in 54 men and 23 women with either acute injuries (54) or with traumatic sequelae (23) of a fracture of the radial head. Four designs of RHA were used, including the Guepar (Small Bone Innovations (SBi)/Stryker; 36), Evolutive (Aston Medical; 24), rHead RECON (SBi/Stryker; ten) or rHead STANDARD (SBi/Stryker; 7) prostheses. The mean follow-up was 74.0 months (standard deviation (sd) 38.6; 24 to 141). The indication for further surgery, range of movement, mean Mayo Elbow Performance (MEP) score, quick Disabilities of the Arm, Shoulder and Hand (quickDASH) score, osteolysis and positioning of the implant were also assessed according to the design, and acute or delayed use.


The Bone & Joint Journal
Vol. 103-B, Issue 3 | Pages 462 - 468
1 Mar 2021
Mendel T Schenk P Ullrich BW Hofmann GO Goehre F Schwan S Klauke F

Aims

Minimally invasive fixation of pelvic fragility fractures is recommended to reduce pain and allow early mobilization. The purpose of this study was to evaluate the outcome of two different stabilization techniques in bilateral fragility fractures of the sacrum (BFFS).

Methods

A non-randomized, prospective study was carried out in a level 1 trauma centre. BFFS in 61 patients (mean age 80 years (SD 10); four male, 57 female) were treated surgically with bisegmental transsacral stablization (BTS; n = 41) versus spinopelvic fixation (SP; n = 20). Postoperative full weightbearing was allowed. The outcome was evaluated at two timepoints: discharge from inpatient treatment (TP1; Fitbit tracking, Zebris stance analysis), and ≥ six months (TP2; Fitbit tracking, Zebris analysis, based on modified Oswestry Disability Index (ODI), Majeed Score (MS), and the 12-Item Short Form Survey 12 (SF-12). Fracture healing was assessed by CT. The primary outcome parameter of functional recovery was the per-day step count; the secondary parameter was the subjective outcome assessed by questionnaires.


The Bone & Joint Journal
Vol. 96-B, Issue 1 | Pages 59 - 64
1 Jan 2014
Weston-Simons JS Pandit H Kendrick BJL Jenkins C Barker K Dodd CAF Murray DW

Mobile-bearing unicompartmental knee replacements (UKRs) with a flat tibial plateau have not performed well in the lateral compartment, owing to a high dislocation rate. This led to the development of the Domed Lateral Oxford UKR (Domed OUKR) with a biconcave bearing. The aim of this study was to assess the survival and clinical outcomes of the Domed OUKR in a large patient cohort in the medium term.

We prospectively evaluated 265 consecutive knees with isolated disease of the lateral compartment and a mean age at surgery of 64 years (32 to 90). At a mean follow-up of four years (sd 2.2, (0.5 to 8.3)) the mean Oxford knee score was 40 out of 48 (sd 7.4). A total of 12 knees (4.5%) had re-operations, of which four (1.5%) were for dislocation. All dislocations occurred in the first two years. Two (0.8%) were secondary to significant trauma that resulted in ruptured ligaments, and two (0.8%) were spontaneous. In four patients (1.5%) the UKR was converted to a primary TKR. Survival at eight years, with failure defined as any revision, was 92.1% (95% confidence interval 81.3 to 100).

The Domed Lateral OUKR gives good clinical outcomes, low re-operation and revision rates and a low dislocation rate in patients with isolated lateral compartmental disease, in the hands of the designer surgeons.

Cite this article: Bone Joint J 2014;96-B:59–64.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 422 - 422
1 Sep 2012
Weston-Simons J Pandit H Kendrick B Beard D Gibbons M Jackson W Gill H Price A Dodd C Murray D
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Introduction

The options for the treatment of the young active patient with unicompartmental symptomatic osteoarthritis and pre-existing Anterior Cruciate Ligament (ACL) deficiency are limited. Patients with ACL deficiency and end-stage medial compartment osteoarthritis are usually young and active. The Oxford Unicompartmental Knee Replacement (UKA) is a well established treatment option in the management of symptomatic end-stage medial compartmental osteoarthritis, but a functionally intact ACL is a pre-requisite for its satisfactory outcome. If absent, high failure rates have been reported, primarily due to tibial loosening. Previously, we have reported results on a consecutive series of 15 such patients in whom the ACL was reconstructed and patients underwent a staged or simultaneous UKA. The aim of the current study is to provide an update on the clinical and radiological outcomes of a large, consecutive cohort of patients with ACL reconstruction and UKA for the treatment of end-stage medial compartment osteoarthritis and to evaluate, particularly, the outcome of those patients under 50.

Methods

This study presents a consecutive series of 52 patients with ACL reconstruction and Oxford UKA performed over the past 10 years (mean follow-up 3.4 years). The mean age was 51 years (range: 36–67). Procedures were either carried out as Simultaneous (n=34) or Staged (n=18). Changes in clinical outcomes were measured using the Oxford Knee Score (OKS), the change in OKS (OKS=Post-op − Pre-op) and the American Knee Society Score (AKSS). Fluoroscopy assisted radiographs were taken at each review to assess for evidence of loosening, radiolucency progression, (if present), and component subsidence.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 348 - 348
1 Jul 2008
Ashmore A Gozzard C Blewitt N
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Aims: To review the results from a series of GSB III total elbow arthroplasties performed at an independent centre. Between 1996 and 2004 the senior author performed 58 total elbow arthroplasties in 44 patients (10 males, 34 females) using the GSB III implant. These were reviewed and the outcome assessed through the use of a patient-answered questionnaire and clinical and radiological review. Mean age was 65 (49 to 84 years). Indications for surgery included rheumatoid arthritis (46 elbows) and post-traumatic osteoarthritis (11 elbows). Mean F/up was 4.1 years (0.8 to 8.5 years). 4 patients had died (6 elbows) and 4 patients (4 elbows) were unavailable for review. 2 of the implants had been revised (1x aseptic loosening, 1x deep infection), leaving a total of 46 elbows available for review. The survival rate at a mean of 4 years was 98% with aseptic loosening as the endpoint. Complications included 1 case of intraoperative fracture and 1 persistent ulnar neuritis. Overall patient satisfaction was high. The mean Mayo Elbow Performance Score was 83 out of 100 (range, 34 to 100) and mean Liverpool Elbow Score was 8 out of 10 (range, 1 to 10).

Conclusion: Previous studies of outcome following total elbow arthroplasty using the GSB III elbow prosthesis at independent centres have shown satisfactory results, but have looked at small groups of patients. Our results offer more robust data to show that the medium term outcome following total elbow arthroplasty using the GSB III prosthesis is satisfactory.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 341 - 341
1 Jul 2008
Ashmore A Gozzard C Blewitt N
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Aims: To review the results from a series of GSB III total elbow arthroplasties performed at an independent centre.

Between 1996 and 2004, the senior author performed 58 total elbow arthroplasties in 44 patients (10 males, 34 females) using the GSB III implant. These were reviewed and the outcome assessed through the use of a patient-answered questionnaire and clinical and radiological review. Mean age was 65 (49 to 84 years). Indications for surgery included rheumatoid arthritis (46 elbows) and post-traumatic osteoarthritis (11 elbows). Mean F/up was 4.1 years (0.8 to 8.5 years). Four patients had died (six elbows) and four patients (four elbows) were unavailable for review. Two of the implants had been revised (1x aseptic loosening, 1x deep infection), leaving a total of 46 elbows available for review. The survival rate at a mean of four years was 98% with aseptic loosening as the endpoint.

Complications included one case of intraoperative fracture and one persistent ulnar neuritis. Overall patient satisfaction was high. The mean Mayo Elbow Performance Score was 83 out of 100 (range, 34 to 100) and mean Liverpool Elbow Score was 8 out of 10 (range, 1 to 10).

Conclusion: Previous studies of outcome following total elbow arthroplasty using the GSB III elbow prosthesis at independent centres have shown satisfactory results, but have looked at small groups of patients. Our results offer more robust data to show that the medium term outcome following total elbow arthroplasty using the GSB III prosthesis is satisfactory.


The Journal of Bone & Joint Surgery British Volume
Vol. 91-B, Issue 8 | Pages 1044 - 1048
1 Aug 2009
Jackson MP Sexton SA Walter WL Walter WK Zicat BA

We evaluated 535 consecutive primary cementless total knee replacements (TKR). The mean follow-up was 9.2 years (0.3 to 12.9) and information on implant survival was available for all patients. Patients were divided into two groups: 153 obese patients (BMI ≥ 30) and 382 non-obese (BMI < 30). A case-matched study was performed on the clinical and radiological outcome, comparing 50 knees in each group. We found significantly lower mean improvements in the clinical score (p = 0.044) and lower post-operative total clinical scores in the obese group (p = 0.041). There was no difference in the rate of radiological osteolysis or lucent lines, and no difference in alignment. Log rank test for survival showed no significant differences between the groups (p = 0.167), with a ten-year survival rate of 96.4% (95% confidence interval (CI) 92 to 99) in the obese and 98% (95% CI 96 to 99) in the non-obese.

The mid-term survival of TKR in the obese and the non-obese are comparable, but obesity appears to have a negative effect on the clinical outcome. However, good results and high patient satisfaction are still to be expected, and it would seem unreasonable to deny patients a TKR simply on the basis of a BMI indicating obesity.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_17 | Pages 8 - 8
1 Nov 2014
Titchener A Duncan N Rajan R
Full Access

Introduction:

This study evaluates the mid-term results of first metatarsophalangeal joint replacement (MTPJR) for hallux rigidus using the Toefit-Plus™ prosthesis.

Methods:

We prospectively studied the outcomes of 86 MTPJR in 73 patients using the AOFAS-HMI score and radiological follow up over a period from 2006 to 2013, with surgeries performed by a single surgeon at two centres. Patients were reviewed, scored and radiographs obtained pre-operatively and then at intervals of 6 weeks, 6 months, 12 months and then yearly. The mean follow up was 33 months (2–72).


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 134 - 134
1 May 2016
Plachel F Heuberer P Schanda J Pauzenberger L Anderl W
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Background

The use of reverse total shoulder arthroplasty considerably increased since first introduced by Paul Grammont in the late 1980s. Over the past few years, results from several mid- and long-term clinical studies have demonstrated good functional outcomes and pain relief. However, several complications, especially inferior glenoid notching, and high revision rates were reported in the literature. Improvements in prosthesis design should contribute to a lower complication rate and lesser amount of glenoid erosion. Few studies have reported the clinical outcome andcomplications of Anatomical Shoulder Inverse/ Reverse Prosthesis. This study documents 2- and 6-year clinical and radiological results following reversed shoulder arthroplasty using this novel prosthesis.

Methods

We report the results for sixty-eight consecutive patients (seventy shoulders) with cuff tear arthropathy (CTA) treated with Anatomical Shoulder Inverse/Reverse Prosthesis between 2006 and 2008. Two groups were defined: (A) primary treatment and (B) revision. Clinical evaluation tools comprised Constant-Murley score (CS), range of motion, and a visual analog scale to assess pain. Radiographs (anteroposterior view in neutral position) were evaluated for notching and radiolucent lines. Any complications were recorded.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 503 - 504
1 Nov 2011
Zehi K Boundka A Tlil N Jeridi Y Zouari M
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Purpose of the study: The tibial slope is an important parameter for knee surgery. Tibial slope designates the inclination of the tibial plateaus in the sagittal plane. The presence of a tibial slope and its value is intimately related to the condylotrochleal profile. The importance of tibial slope in knee disease and knee surgery is now universally recognised.

Material and method: We reviewed 140 cases of anterior cruciate ligament (ACL) ligamentoplasty performed at the institute; 25 failures were identified. After analysis of the position of the tunnels, particularly the femoral tunnels, the most documented cause of failure, as well as other factors of failure, we measured the mean tibial slope in all operated patients.

Results: Subjective Lachmann and the IKDC and ARPEGE scores associated with the dynamic study (TELOS) helped understand why knees can become unstable despite good surgical technique.

Discussion: William and Lissner established a mathematical relations between tibial slope and stress forces applied to the ACL. Dejour and Bonnin demonstrated the effect of the tibial slope on anterior subluxation and single leg stance. The tibial slope should thus be considered for all knee procedures. Bonnin demonstrated that an excessive slope can be a factor of plasty failure.


The Bone & Joint Journal
Vol. 100-B, Issue 2 | Pages 197 - 204
1 Feb 2018
Gaspar MP Pham PP Pankiw CD Jacoby SM Shin EK Osterman AL Kane PM

Aims

The aims of this study were to compare the mid-term outcomes of patients with late-stage arthritis of the wrist treated with proximal row carpectomy (PRC) and dorsal capsular interposition (DCI) arthroplasty with a matched cohort treated with routine PRC alone.

Patients and Methods

A total of 25 arthritic wrists (24 patients) with pre-existing degenerative changes of the proximal capitate and/or the lunate fossa of the radius were treated with PRC + DCI over a ten-year period. This group of patients were matched 1:2 with a group of 50 wrists (48 patients) without degenerative changes in the capitate or lunate fossa that were treated with a routine PRC alone during the same period. The mean age of the patients at the time of surgery was 56.8 years (25 to 81), and the demographics and baseline range of movement of the wrist, grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were similar in both groups.


The Bone & Joint Journal
Vol. 96-B, Issue 9 | Pages 1264 - 1268
1 Sep 2014
Gelfer Y Dunkley M Jackson D Armstrong J Rafter C Parnell E Eastwood DM

Previous studies have identified clinical and demographic risk factors for recurrence in the treatment of idiopathic clubfoot (congenital talipes equinovarus). Evertor muscle activity is not usually considered amongst them. This study aimed to evaluate whether recurrence could be predicted by demographic, clinical and gait parameters. From a series of 103 children with clubfeet, 67 had completed a follow-up of two years: 41 male and 26 female, 38 with idiopathic and 29 with non-idiopathic deformities. The mean age was 3.2 years (2.1 to 6.3). Primary correction was obtained in all 38 children (100%) with an idiopathic deformity, and in 26 of 29 patients (90%) with a non-idiopathic deformity. Overall, 60 children (90%) complied with the abduction brace regime. At a mean follow-up of 31.4 months (24 to 62), recurrence was noted in six children (15.8%) in the idiopathic and 14 children (48.3%) in the non-idiopathic group. Significant correlation was found between poor evertor activity and recurrence in both groups. No statistically significant relationship was found between the rate of recurrence and the severity of the initial deformity, the age at the time of treatment, the number of casts required or the compliance with the brace.

After correction of idiopathic and non-idiopathic clubfoot using the Ponseti method, only poor evertor muscle activity was statistically associated with recurrence. The identification of risk factors for recurrent deformity allows clinicians to anticipate problems and advocate early additional treatment to improve muscle balance around the ankle.

Cite this article: Bone Joint J 2014;96-B:1264–8.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 390 - 390
1 Jul 2010
Grammatopoulos G Pandit H Kwon Y Singh P Gundle R McLardy-Smith P Beard D Gill H Murray D
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Introduction: Metal on metal Hip Resurfacing Arthroplasty (MoMHRA) has gained popularity due to its perceived advantages of bone conservation and relative ease of revision to a conventional THR if it fails. This retrospective study is aimed at assessing the functional outcome of failed MoMHRA revised to THR and comparing it with a matched cohort of primary THRs.

Method: Since 1999 we have revised 53 MoMHRA to THR. The reasons for revision were femoral neck fracture (Group A, n=21), pseudotumour (Group B, n=16) and other causes (Group C, n=16: loosening, avascular necrosis and infection). Average follow-up was 3 years months (1.2–7.3). These revisions were compared with 106 primary THRs which were age, gender and follow-up matched with the revision group in a ratio of 2:1.

Results: The mean Oxford Hip Score (OHS) was 20.1 (12–51) for group A, 39.1 (14– 56) for group B, 22.8 (12–39) for group C and 17.8 (12–45) for primary THR group. In group A, there were three infections requiring further revisions. In group B, there were three recurrent dislocations, three patients with femoral nerve palsy and one femoral artery stenosis. In group C, there were no complications. The differences in clinical and functional outcome between group B and the remaining groups as well as the difference in the outcome between group B and control group were statistically significant (p < 0.05).

Conclusions: THR for failed MoMHRA was associated with significantly more complications, operation time and need for blood transfusion for the pseudotumour group. In addition, the revisions secondary to pseudotumour also had significantly worse functional outcome when compared to other MoMHRA revisions or primary THR.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_I | Pages 62 - 62
1 Mar 2002
Pidhorz L Ridereau P Cadu C
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Purpose: Loosening and wear of the polyethylene insert remains an important problem after ten years. The Harris-Galante 1 (HGP1) press fit titanium backed cup appears to provide an interesting alternative. We studied the clinical and radiological outcome of 191 total hip arthroplasties performed between June 1985 and June 1990.

Material and methods: This prospective continuous series included 174 patients (191 hips), 76 women and 98 men, mean age 62.1 years (19–83). The posterior approach was used in all cases for treatment of degenerative hip disease (80%) or osteonecrosis (14.6%). The polyethylene-metal cup was used with a 28mm head in 90.7% of the cases. The press-fit cup was fixed with three screws. At review, 39 patients had died (45 hips), 25 were contacted for a phone interview, and two were lost to follow-up; 119 patients were re-examined and had a standard radiography series at last follow-up. Mean follow-up was 11.9 years (10–15). The Postel Merle d’Aubigné (PMA) score and the Harris hip score (HHS) were used to assess outcome. Quality of bone fixation and cup migration were studied as were lucent lines classed according to De Lee. Wear was calculated using the Livermore method and osteolysis using the Mulroy method. Actuarial survival curves were plotted using reoperation as the end-point if the polyethylene insert was changed or revision if the cup was changed for any reason. Qualitative data were compared using chi square test.

Results: There was one death on day three and three dislocations including two requiring reoperation for an insert overhang. The PMA pain score improved from 2.58 to 5.5 and the overall PMA score from 10.5 to 16.2. the HHS improved from 53.5 to 87.2 points. A lucent line measuring < 1 mm was found in 12 cases; one was complete, nine were in a single zone. Osteolysis was found in 28 cases and was qualified as severe in four. Mean polyethylene wear was 0.1 mm (volume 65.5 mm3). There was no case with cup migration or cup tilt and none of the cups had to be changed. Five polyethylene inserts were changed due to wear at a mean 145 months. The actuarial survival curve taking into account the seven insert changes showed a mean 15-year survival of 96.7±3%.

Discussion: The Harris-Galante press-fit cup has exhibited good behaviour at a mean 11.9 years follow-up. Mean annual wear was = 0.1 mm in 42 patients; it was > 0.2 mm in 18 patients including five who required reoperation to change the insert at 145 months. Osteolysis was noted in 28 cases, an important problem.

Conclusion: With only two patients lost to follow-up at ten years, this prospective review demonstrates well that the press-fit cup is well tolerated which has suffered from comparison with cemented cups. Five worn inserts had to be changed, requiring a simple operation. There were four cases of severe osteolysis.