Patterns of failure in the original Besser bipolar prosthesis

Fourteen original Besser endoprostheses inserted in young patients with osteonecrosis of the femoral head were reviewed. Two cups dislocated early and 1 other required replacement due to acetabular degeneration. Component disassembly occurred in 4 hips, which had exhibited persistently vertical cups. Their stems revealed notching medially and the cups showed gross erosion and failure. The remaining 5 hips were mobile and pain free, but in 3 of these the cups exhibited a persistently vertical orientation and, as such, are predisposed to failure. Only one article reporting early good results using this prosthesis has been published. The failure rate of 50% in this series is disappointing.