The femoral component in low-friction arthroplasty after ten years

In 623 low-friction arthroplasties ten years after implantation, 70 hips (18.04% after 16 years) showed loosening of the femoral component. Eighty-four percent appeared within ten years. Fracture of the stem occurred in 4.3% of cases after 16 years, and resorption over 5 mm of the femoral neck occurred in 9.3%. Calcar cysts appeared in 2.9% and endosteal cavitations in 18.04% after 16 years; both findings were related to acetabular wear greater than 2 mm. Gruen's Type III (calcar pivot) was the least common loosening (6.8%) during the first ten years. After this time its incidence increased to 17.1%. Loosening of the femoral component was not related to age, weight, or activity. It was, however, associated with poor surgical technique, i.e., varus position (46%), cementation defects (34%), and/or femoral neck osteotomy on the lesser trochanter (36%).