Cementless Total Hip Arthroplasty Using the ABG I Hydroxyapatite-coated Prosthesis: Minimum 10 Year Follow-up

Yee-Suk Kim; Dong-Hyuck Park; Kyu-Tae Hwang; Young-Ho Kim; Il-Yong Choi

doi:10.5371/hp.2013.25.3.166

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Kim, Park, Hwang, Kim, and Choi: Cementless Total Hip Arthroplasty Using the ABG I Hydroxyapatite-coated Prosthesis: Minimum 10 Year Follow-up

Original Article

Hip & Pelvis 2013; 25(3): 166-172.

Published online: 30 September 2013

DOI: https://doi.org/10.5371/hp.2013.25.3.166

Cementless Total Hip Arthroplasty Using the ABG I Hydroxyapatite-coated Prosthesis: Minimum 10 Year Follow-up

Yee-Suk Kim, MD, Dong-Hyuck Park, MD, Kyu-Tae Hwang, MD, Young-Ho Kim, MD^*, Il-Yong Choi, MD

Department of Orthopedic Surgery, Hanyang University Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, Korea.

Address reprint request to Young-Ho Kim, MD. Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 249-1 Kyomun-dong, Guri 471-701, Korea. TEL: +82-31-560-2312, FAX: +82-31-557-8781, kimyh1@hanyang.ac.kr

Received 4 July 2013 Revised 4 September 2013 Accepted 5 September 2013

(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 outcomes of total hip arthroplasty (THA) with an ABG I hip prosthesis after a minimum ten-year follow up.

Materials and Methods

From January 1996 to March 2001, 121 hips in 104 patients, whi were followed up for a minimum of ten-years, were enrolled in this study. The clinical and radiographic outcomes were evaluated and Kaplan-Meier survival analysis was performed.

Results

The mean Harris hip score at the last follow-up was 84 points. A radiolucent line around the cup, osteolysis, and cup loosening were observed in 5 hips(4.1%), 53 hips(43.8%), and 5 hips(4.1%), respectively. In the femoral side, osteolysis and stem loosening were observed in 11 hips(9.1%) and 2 hips(1.7%), respectively. The mean linear wear rate of the polyethylene liner was 0.23 mm/yr. Forty four revisions(36.3%) were performed. The outcomes were similar regardless of the cause of primary THA. The survival rate with the end point of revision due to cup loosening was 56.3%, and revision due to stem loosening was 98.1% after a 16 year follow-up.

Conclusion

High polyethylene wear and the disappointing survival rate of the ABGI cup were observed after a minimum ten year follow-up. Therefore, close observation of patients who have received an ABG I prosthesis is necessary.

Keywords: Hip, ABG I, Osteolysis, Polyethylene wear

Figures and Tables

Fig. 1

Photographs of ABG I hip prosthesis (Anatomique Benoist Gerard; Stryker Howmedica Osteonics, Newbury, UK) (A) a cementless, anatomical design comprising a hydroxyapatite (HA) coated titanium stem, designed for proximal metaphyseal fixation, and (B) an acetabular component comprising a HA coated hemispherical titanium shell with a polyethylene liner.

Fig. 2

Measurement of polyethylene wear rate with the Scheier-Sandel method. The head center is constructed with a template, (a-b)/2 and c are used for calculation of the wear.

Fig. 3

A 45-year-old female patient underwent THA with the ABG I prosthesis for rheumatoid arthritis of the left hip joint. (A) Preoperative radiography showed joint space narrowing and protruded femoral head into the acetabulum. (B) Bone ingrowth and stable fixation of the acetabular cup were showed at 3 year after THA. (C) At 13.2 years after THA, the patient complained of inguinal pain and radiography showed eccentric joint center due to excessive polyethylene wear(0.42 mm/yr) and massive osteolysis around the acetabular cup.

Fig. 4

Kaplan-Meier survivorship curve of the ABG-I total hip arthroplasty (THA). (A) The survival rate at 16 years of follow-up with the end point of revision due to cup loosening was 56.3% and (B) survival rate was 98.1% with the end point of revision due to stem loosening.

Table 1

Clinical and Radiographic Outcomes of Primary Total Hip Arthroplasty using ABG I Prosthesis

Table 2

Linear Wear Rate of Polyethylene Liner

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