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Cementless cup device developed for hip replacements shows durability after more than 20 years
Date:2/2/2009

f 20 years.

Of the original cohort of 138 hips, researchers were able to follow 73 patients who were still living (77 hips) for 20 years or more. Of the 77 hips, 37 had both clinical and radiographic evaluation, 20 had a clinical evaluation via telephone questionnaire and 21 underwent a repeat revision of the acetabular metal shell.

Twenty of the 21 cementless cups were found to be well fixed at the time of repeat revision and only one had become loose. During the entire study period, four cups were identified radiographically as being loose. For the entire cohort of 138 hips, the 20-year survivorship of the acetabular component was 95 percent.

While the long-term fixation of the device performed very well, the study did find an increased rate of repeat surgery for wear-related complications compared to the 15-year report. Ten patients, or 18 percent, had a complication related to wear of the bearing surface as opposed to 3 percent at 15 years.

"Although we have seen more complications related to wear as we have continued to follow these patients, our studies have taught us valuable lessons regarding failure mechanisms and how to avoid them," said Della Valle.

Despite the increasing prevalence of wear-related problems, the main modes of failure were infection and recurrent dislocations. The study authors recommend the use of larger diameter femoral heads and more wear-resistant bearings to decrease the risks of these complications.

"We can continue to make vast improvements in the quality of bearing and stability in the next generation of devices used in total hip replacements with the information we have gathered from this study," said Galante. "More and more patients are living longer and we must continue to further develop sustainable devices that will give patients a better quality of life."


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Contact: Deborah Song
deb_song@rush.edu
312-942-0588
Rush University Medical Center
Source:Eurekalert

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