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KMID : 0386720030150010078
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Journal of the Korean Hip Society
2003 Volume.15 No. 1 p.78 ~ p.86
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Six to Ten Year Follow-up Study of Primary Hybrid Total Hip Arthroplasty using a Precoate Stem
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Shon Won-Yong
Hur Chong-Yong
Moon Jun-Gyu
Rho YJ
Jung SH
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Abstract
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Purpose: We reviewed the results of 105 primary hybrid total hip replacements, performed by one surgeon between October 1991 and August 1995, using a cemented polymethyl-methacrylate coated femoral prosthesis (Precoat) and contemporary cementing techniques.
Materials and Methods: The acetabular implants used included: 69 porous-coated hemispherical Zimmer cups (HG), 10 Protek extension cups and 2 Wagner threaded cups. Nine patients died before the minimum 6 years of follow up, 2 were too ill for detailed follow-up examinations at the time of the study. 13 patients in total were lost to follow-up. 79 patients (Eight-one hips) were available for clinical follow-up, with an average of 8.2 years, ranging from 72 to 130 months. The average age of the patients at the time of the index operation was 53.6, ranging from 24 to 82 years.
Results: Three porous-coated acetabular (3.2%) components were revised: 2 (2.2%) for cup looseining, and 1 (1.1%) for a dissociation of the liner in association with a fracture of a locking tine. One extension cup was revised at the same time as a femoral stem due to an aseptic loosening. Seven femoral components (8.6%) were revised due to aseptic loosening in 6 cases) and a dislocation in 1. Overall, the prevalence of aseptic femoral stem loosening was 8.6% (7 of 81 hips). Of seven hips, 1 hip had a Grade B cement mantle and 6 had Grade C cement mantles, including 5 with C-2 defects. Five out of the 6 hips with definitive loosening, showed stem-bone cement in zone Ⅰ 6 years after the operation. The clinical results of the 71 retained hips were good or excellent in 61 (86%), with the average Harris hip score being 88 points, ranging from 67 to 100 points.
Conclusion: Our results suggested that an early failure of the Precoat femoral stem was mainly as a result of an insufficient cementing technique (thin cement mantle). The inherent effects of the stem design may also accelerate the mechanism of failure.
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KEYWORD
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Hybrid total hip arthroplasty, Precoated femoral stem, Cement technique
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