Eight to Eighteen Years Follow Up Study of Primary Hybrid Total Hip Arthroplasty Using a Precoat Femoral Stem

Sang Heon Song; Young Jae Hur; Ho Hyun Yun; Jong Keon Oh; Chang Yong Hu; Won Yong Shon

doi:10.4055/jkoa.2011.46.2.107

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Song, Hur, Yun, Oh, Hu, and Shon: Eight to Eighteen Years Follow Up Study of Primary Hybrid Total Hip Arthroplasty Using a Precoat Femoral Stem

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2011; 46(2): 107-113.

Published online: 22 April 2011

DOI: https://doi.org/10.4055/jkoa.2011.46.2.107

Eight to Eighteen Years Follow Up Study of Primary Hybrid Total Hip Arthroplasty Using a Precoat Femoral Stem

Sang Heon Song, M.D., Young Jae Hur, M.D., Ho Hyun Yun, M.D., Ph.D.^*, Jong Keon Oh, M.D., Ph.D., Chang Yong Hu, M.D., Ph.D., Won Yong Shon, M.D., Ph.D.

Department of Orthopedic Surgery, Korea University Medical Center, Seoul, Korea.

^*Department of Orthopedic Surgery, Seoul Veterans Hospital, Seoul, Korea.

Correspondence to: Won Yong Shon, M.D., Ph.D. Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, Guro 2-dong, Guro-gu, Seoul 152-703, Korea. TEL: +82-2-2626-3085, FAX: +82-2-2626-1164, wonyong@kumc.or.kr

Received 16 December 2009 Accepted 12 February 2011

(open-access):

"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited."

Abstract

Purpose

The purpose of this study was to evaluate the 15.5 year long term survival rate of the Precoat femoral stem.

Materials and Methods

We reviewed the results of 105 primary hybrid total hip replacements (98 patients) that were performed by one surgeon between October 1990 and August 1995 using a cemented polymethyl-methacrylate coated femoral prosthesis (Precoat) and contemporary cementing techniques. Thirty four patients (34 hips) died and seventeen patients (17 hips) were lost to follow-up. Forty seven patients (54 hips) were available for clinical follow-up, with an average follow-up period of 15.5 years (range: 8.4 to 18.3 years). The average age of the patients at the time of the index operation was 46 years (range: 22 to 67 years). There were 32 male patients (37 hips) and 15 female patients (17 hips).

Results

For the acetabular component, 15 hips (27.8%) were revised for cup loosening and isolated liner exchange was performed in 12 hips (22.2%) for liner wear and osteolysis. For the femoral component, 12 hips (22.2%) were revised due to aseptic loosening. Of these twelve hips, 3 hips had Grade B cement mantles and 9 had Grade C cement mantles. The clinical results of the 54 retained hips were good or excellent in 52 hips (96.3%) with the average Harris hip score being 88 points (range: 72 to 96 points).

Conclusion

The mean 15.5 years' survival rate of the Precoat cemented femoral stem was 78%. We think that there were several factors for the failure of femoral stem fixation, including age, physical activity and the body weight, as well as the stem design and the surgical technique had an influence on the stem's survival.

Keywords: precoat femoral stem, long term survival, loosening of cemented femoral stem

Figures and Tables

Figure 1

(A, B) Two radiographs show definitive loosening with cement-stem failure.

Figure 2

This radiograph shows cement-bone interface failure with cement-stem debonding in Gruen zone I.

Figure 3

This radiograph shows cement-bone interface failure and severe lysis in zones 3 to 6.

Figure 4

AP and lateral radiographs show definitive loosening. Lateral view shows loosening of cement mantle with C2 defect in zone 12.

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