Cementless acetabular replacement in the young. A 5- to 10-year prospective study

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• The cementless Harris-Galante porous-coated acetabular component is utilized in total hip replacements.
• Younger patients (≤50 years) undergoing hip arthroplasty present unique challenges due to higher activity levels and longer lifespan expectations.

Purpose of the Study:

• To evaluate the clinical and radiologic outcomes of the cementless Harris-Galante acetabular component in patients aged 50 years or younger.
• To assess the medium-term fixation, wear, and revision rates associated with this component.

Main Methods:

• Prospective clinical and radiologic review of 55 total hip replacements in 50 patients.
• Minimum 5-year follow-up (mean 7 years).
• Analysis of component fixation, radiolucent lines, polyethylene wear, and revision causes.

Main Results:

• No acetabular component revisions for loosening or migration were reported.
• Excellent component fixation was observed in the medium term.
• A high incidence of polyethylene liner exchange (10.9%) due to excessive wear was noted, with an additional 7.3% showing significant wear.
• Revised liners were associated with 32-mm femoral heads and initial polyethylene thickness < 6 mm.

Conclusions:

• The cementless Harris-Galante acetabular component demonstrates excellent fixation in young patients with medium-term follow-up.
• The incidence of polyethylene liner wear is unacceptably high, potentially linked to the use of 32-mm femoral heads and reduced polyethylene thickness in metal-backed components.
• Further research is needed to address accelerated wear patterns and improve long-term outcomes in this patient population.