Further follow-up on socket fixation using a metal-backed acetabular component for total hip replacement. A minimum ten-year follow-up study.

In 1982, Harris and White reported the data after a minimum five-year follow-up of fifty-three total hip replacements in forty-seven patients in whom a cemented metal-backed acetabular component had been used. There actually had been fifty-four total hip replacements in fifty-three hips, as in one hip a revision was done for a traumatic disruption of the initial acetabular component that occurred two months after the first insertion. Six of the fifty-four operations did not qualify for inclusion in this ten-year follow-up study, including four operations in three patients who had died before that time. The remaining forty-eight hips have been followed for ten to 13.5 years (mean, 11.3 years). With one exception, the ages of the patients at the time of the index operation ranged from seventeen to fifty years (mean, forty-one years). Six (12.5 per cent) of the forty-eight hips required revision because of symptomatic aseptic loosening of the acetabular component. In addition, two acetabular components, although they were not loose, were revised concomitantly with revision of the femoral component because of the presence of radiolucent lines at the cement-bone interface of the acetabular implant. One other acetabular component that was not loose was revised because of unexplained pain, one was removed because of sepsis, and for one only the polyethylene liner was exchanged because of damage to the polyethylene when the weld holding the femoral head to the femoral neck failed. Nine additional hips (19 per cent), although they were not revised, showed radiographic evidence of migration, and one (2 per cent) showed radiographic evidence of impending failure.(ABSTRACT TRUNCATED AT 250 WORDS)