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KMID : 0386720010130010008
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Journal of the Korean Hip Society
2001 Volume.13 No. 1 p.8 ~ p.19
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Long Term Results of the Cementless Porous Coated Harris-Galante Total Hip Prosthesis
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Yoo Myung-Chul
Cho Yoon-Je
Chun Young-Soo
Pyo Na-Sil
Kim Sung-Geun
Shin Dong-Jun
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Abstract
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Purpose: To analyze the long term clinical and radiographic results of total hip arthroplasty using cementless porous coated Harris-Galante (H-G) stem.
Materials & Methods: A total of 134 hips from 114 consecutive patients who had undergone total hip arthroplasty using the cementless H-G stem over a four year period between February 1986 and April 1990 formed the basis of this study. The minimum follow-up period was 10 years. The clinical evaluation was done by measuring the modified Hams hip score and thigh pain regularly each year. The radiographic evaluation was done by measuring radiolucent line, subsidence, subcollar resorption, osteolysis, cortical hypertrophy, pedestal formation, stress shielding and stem stability.
Results: The average Hams hip score increased from 58 points preoperatively to 85 points at the most recent follow-up examination. The hip pain score increased from 31 points to 41 points over the same period. Clinically moderate thigh pain was observed in 5 cases (4%). In radiographic evaluation, subsidence of more than 5mm was seen in 4 cases (3%). Periprosthetic osteolytic lesions were observed in 24 cases (18%), however in all cases the lesion did not influence the stability of the stem. One case was revised due to multifocal osteolysis. The femoral stem stability as measured by Engh´s criteria was stable in 109 cases, fibrous stable in 20 cases, and unstable in 5 cases. Pedestal formation, cortical hypertrophy of the distal femur, and stress shielding was observed in 37%, 43%, and 43% of the cases, respectively. Calcar resorption was identified in 31% of the cases and ectopic ossification in 13%. Revision of the femoral stem was required in 6 cases for aseptic loosening (5 cases) and osteolysis(1 case). At 10 years, the probability of survival of the stem as measured by the Kaplan-Meier method was 94.4%.
Conclusions: Use of the cementless H-G stem yields an excellent long-term outcome, however osteolysis, calcar resorption, and stress shielding were the main problems observed.
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KEYWORD
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Harris-Galante, Total hip arthroplasty, Cementless HG stem
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