J Korean Orthop Assoc.  2011 Apr;46(2):107-113.

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

• Song SH
• Hur YJ
• Yun HH
• Oh JK
• Hu CY
• Shon WY

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.

Keyword

precoat femoral stem; long term survival; loosening of cemented femoral stem

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip
Body Weight
Chimera
Female
Follow-Up Studies
Hip
Humans
Lost to Follow-Up
Male
Motor Activity
Osteolysis
Prostheses and Implants
Survival Rate

Figure

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  Figure 1 (A, B) Two radiographs show definitive loosening with cement-stem failure.

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  Figure 2 This radiograph shows cement-bone interface failure with cement-stem debonding in Gruen zone I.

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

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  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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