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KMID : 0386720010130030267
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Journal of the Korean Hip Society
2001 Volume.13 No. 3 p.267 ~ p.278
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Osteolysis in Cementless Total Hip Arthroplasty with harris-Galante Cup and Stem
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Yoo Myung-Chul
Cho Yoon-Je
Chun Young-Soo
Lee Jung-Hee
Lee Young-Ho
Bae Sung-Chul
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Abstract
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Purpose: A follow up of more than 10 years for the analysis of osteolysis in primary total hip arthroplasties in which the Harris-Galante titanium-fiber-mesh coated proshesis had been inserted without cement.
Materials and Methods: The study consisted of 110 consecutive primary total hip reconstruction patients(126 hips) who had complete radiographic and clinical follow-up. The average age at the time of operation was 42 years(range, 21 to 76 years). The average duratin of follow-up was 13 years(range, 10 to 14 years).
Results: Acetabular osteolysis occurred in 5(4%) hips and femoral osteolysis in 24(19%), also 4 hips with acetabular osteolysis showed femoral osteolysis. There were no significant differences between Harris Galante Ⅰ and Ⅱin terms of osteolysis or wear. The average wear rate was 0.11 ㎜ per year, breaking down to 0.15㎜ per year in the 25 hips with lysis and 0.10 ㎜per year in the 101 hips wihtout lysis. Analyzing by duration, the annual wear rate between 2 and 3 years(Ed- alter-natively, ’in the 3rd year’. Note that ’the 3rd year’ is a period lasting one year) after operation was higher than in any other period. Femoral osteolysis occurred at an average of 50 months(range, 32-117 months) after operation in 24 hips, arising most commonly in zone I and. Even though its size increased in 8(33%) of 24 hips, there was a lack of influence in stability of the femoral stem. Revision surgery was performed in 17 hips(13%0, consisting of 1 case of PE liner and metal shell change due to severe osteolysis, 10 of PE liner change only due to excessive wear, and 6 of stem change of which 1 was due to multifocal osteolysis and 5 to aseptic loosening. Wear, age and preoperative diagnosis were determined to be statistically important prognostic factor associated with osteolysis.
Conclusion: Osteolysis showed no significant influence on prosthesis stability or revisionrate overa follow up period averaging 13 yeras. Patch type porous coating surface design is not sufficiently durable(Ed-or-replace with another
adjective stating exactlyin what way the surface design is not sufficient) to prevent the distal migration of wear debris. Osteolysis and polyethylene liner wear are two of the major issues concerning the long term survival of the Harris Galante cup and stem system.
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KEYWORD
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Cementless total hip arthroplasty, Harris-Galante prosthesis, Osteolysis
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