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Related Experiment Videos

Long-term results using the anatomic medullary locking hip prosthesis.

C A Engh1, A M Claus, R H Hopper

  • 1Anderson Orthopaedic Research Institute, Alexandria, VA 22306, USA.

Clinical Orthopaedics and Related Research
|January 5, 2002
PubMed
Summary

Long-term follow-up of cementless total hip arthroplasty shows polyethylene wear and osteolysis are significant concerns. Osteolysis, particularly pelvic lesions, is linked to acetabular component loosening, emphasizing its importance in revision surgery.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Imaging

Background:

  • Cementless total hip arthroplasty (THA) has shifted focus from component loosening to polyethylene wear and osteolysis.
  • Long-term outcomes of Anatomic Medullary Locking (AML) components require continued evaluation.

Purpose of the Study:

  • To report reasons for revision surgery in a cohort of AML THA.
  • To assess the incidence and size of osteolytic lesions.
  • To investigate the relationship between osteolysis and component loosening.

Main Methods:

  • Review of 223 consecutive AML femoral and acetabular components.
  • Extended follow-up to a mean of 13.9 years (range, 2-18 years).
  • Radiographic analysis of osteolytic lesions and component loosening.

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Main Results:

  • 39 hips (38 patients) underwent 44 component revisions; 22 revisions were due to wear or osteolysis.
  • Overall loosening rates were 3.4% for femoral and 5.4% for acetabular components.
  • 24% of hips showed osteolytic lesions >1.5 cm2; 7 of 11 loose acetabular components were associated with pelvic lesions >1.5 cm2.

Conclusions:

  • Osteolysis, particularly pelvic lesions, is a significant factor contributing to acetabular component loosening in cementless THA.
  • Wear and osteolysis remain critical concerns necessitating long-term monitoring in THA patients.