Over ten-year follow-up results of a prospective and consecutive series of primary total hip arthroplasty with an original cementless total hip prosthesis.

PURPOSE: High survival rates up to ten  years have been reported for non-cemented hip replacements. Publications beyond ten years have more diverse conclusions. To study the long-term survival of uncemented total hip replacement (THR), we examined a series of 125 THR, all with a minimum follow-up of ten  years. METHODS: This is a prospective study of 203 patients operated for coxarthrosis between 2007 and 2011, by six senior surgeons. The original ellipsoidal stem and the impacted acetabulum were systematically cementless; the acetabulum had either a fixed ceramic or polyethylene insert, or a dual-mobility insert. At the date of the follow-up check, 44 patients were deceased and 34 patients were lost to follow-up. This left 125 complete files for our study. RESULTS: They were a revision of the cup in four cases and a revision of the femoral stem in three cases (3.4%). The Kaplan-Meier cumulative survival rate of the THR, by considering revision for any reason as endpoint, at ten  years (120 months) is estimated at 96.6% (CI 92.7-98.7). Radiologically, on 86 analyses (68.8%) at ten  years and more reported, no significant evolution of the appearance of the cancellous bone around the acetabular cup was noted, nor any ossification. Some periprosthetic osteogenesis reactions were noted around the 1/3 distal but no periprosthetic edging. CONCLUSION: In this minimum ten-year follow-up study, a cementless THR with a straight ellipsoidal cementless stem and a press-fit cup provides excellent implant survival and high patient satisfaction. (Clinically felt minimal difference.).

Ten-year results of ALIZE acetabular cup with hydroxyapatite coating and AURA hydroxyapatite-coated stem in total hip arthroplasty.

One hundred seven total hip arthroplasties were done between 1991 and 1992 with ALIZE acetabular cup with hydroxyapatite coating (Biomet France, Valence, France) and AURA hydroxyapatite-coated stem (Biomet France) in 107 patients. The articulation was ceramic on polyethylene for 102 patients and metal on polyethylene for the remaining 5 patients. The mean follow-up of the series was 8.4 +/- 2.5 years. The mean preoperative Merle d'Aubigné hip functional score was 10.6 +/- 3 vs 15.8 +/- 1.8 at the latest follow-up. Sixty-three patients were alive for the long-term follow-up at a mean of 9.67 +/- 0.25 years. Of the patients, 98.5% were satisfied or very satisfied at the latest follow-up. Five revisions were documented in these series: 1 for acetabular loosening, 2 for traumatic ceramic head fracture, 1 for polyethylene replacement, and 1 for stem replacement due to bone fracture. The mean wear rate was 0.076 +/- 0.043 mm/y (<0.1 mm/y considered as the normal wear rate). The overall survival rate at 10 years was 95.6% +/- 2.1% using revision of either component as the end point.