Mid- to Long-Term Outcome of Cementless Total Hip Arthroplasty in Younger Patients

Abstract

Purpose. To assess mid- to long-term outcomes of cementless primary total hip arthroplasty (THA) in younger patients. Methods. Records of 28 women and 34 men (75 hips) aged 18 to 55 (mean, 38) years who underwent primary THA using a hydroxyapatite-coated stem and a threaded cup and had been followed up for a mean of 10 (6–15) years were reviewed. 13 of the patients had bilateral THAs. Clinical and radiographic outcomes were evaluated. Results. After a minimum follow-up of 7 (range, 7–14) years, 12 (16%) of the hips were revised, of which 8 (11%) were for the cup. The causes for revision were late deep infections (n=2), aseptic loosening of the cup (n=4), and polyethylene wear (n=6). No stem was revised for aseptic loosening. Osteolysis was noted in 24 (38%) hips. Of the 63 unrevised hips, the mean Harris Hip Score was 92 (range, 45–100) and the mean D'Aubigne and Postel score was 17 (range, 9–18). The survival of the threaded cup was 88% at 10 years, using revision surgery as the end point. 27 (41%) of the hips showed signs of polyethylene wear; 15 were >2 mm. Conclusion. In younger patients undergoing THA, rates of polyethylene wear and pelvic osteolysis are high, and thus long-term follow-up is crucial.