Noncemented porous-coated anatomic total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Medical Device Design

Background:

• Acrylic fixation has been the standard for total hip arthroplasty.
• The porous-coated anatomic (PCA) hip system was introduced as a cementless alternative in 1984.
• Biologic fixation via porous coatings aims to improve implant longevity.

Purpose of the Study:

• To evaluate the long-term outcomes of the cementless PCA hip system.
• To assess the fixation stability and clinical performance of porous-coated acetabular and femoral components.
• To identify any complications or adverse roentgenographic findings associated with cementless fixation.

Main Methods:

• Follow-up study of 44 patients with cementless acetabular and 35 with cementless femoral components.
• Minimum follow-up of 24 months, average 37 months.
• Evaluation of Harris hip scores, reoperation rates, and roentgenographic signs (bead shedding, radiolucencies, migration, subsidence).

Main Results:

• Average Harris hip score of 90.5.
• No reoperations for acetabular component fixation failure or migration.
• No progressive bead shedding, radiolucencies, or component migration observed.
• Two femoral component revisions (pain, loosening).
• Prevalence of thigh pain (20%) did not compromise hip scores.
• Progressive radiolucencies and implant subsidence were rare.

Conclusions:

• The cementless acetabular component is reliable for total hip arthroplasty when initial stability is achieved.
• Cemented femoral component fixation is preferred for patients over 65 or when initial stability is lacking.
• The PCA hip system demonstrates favorable outcomes, supporting its use in select total hip arthroplasty cases.