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Müller curved-stem total hip arthroplasty: long-term follow-up of 185 consecutive cases
Abstract:
We reviewed 185 consecutive Müller total hip arthoplasties ten to 14 years after operation. Of the 32 patients with 42 arthroplasties who had died within the ten-year period, three had had revisions and five had died of causes related to the operation, including two late infections. Sixty-five hips in 56 living patients were available for clinical and roentgenographic evaluation. An additional 30 hips had been revised for various reasons. When the roentgenographically loose components were combined with the revised ones, the overall incidence of aseptic loosening was 40% for the femoral component and 12.6% for the acetabular component. As previously reported, the combined incidence of loose and revised components at 6 1/2 years was 27.7% for the femoral component and 3.2% for the acetabular component. Therefore, in the intervening five years, the rate of femoral loosening remained about the same, while the rate of acetabular loosening increased. There was a positive correlation between the incidence of loosening of the femoral component and male sex, deficient cementing, and varus position. There was no significant wear of the acetabular component.
Insights
Müller total hip arthroplasty shows a 40% incidence of femoral component aseptic loosening and 12.6% for the acetabular component at 10-14 years. Acetabular loosening rates significantly increased over time.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Clinical orthopedics
Background:
- Total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
- Long-term outcomes and component survival rates are crucial for patient management.
- Müller total hip arthroplasty is a specific design with a history of use.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of Müller total hip arthroplasties.
- To determine the incidence of aseptic loosening for femoral and acetabular components.
- To identify factors associated with component loosening.
Main Methods:
- Retrospective review of 185 consecutive Müller total hip arthroplasties.
- Follow-up period of 10 to 14 years post-operation.
- Clinical and radiographic evaluation of surviving hips, with analysis of revised components.
Main Results:
- Overall incidence of aseptic loosening was 40% for the femoral component and 12.6% for the acetabular component.
- Femoral loosening rate remained stable between 6.5 and 10-14 years, while acetabular loosening increased.
- Positive correlations for femoral loosening included male sex, deficient cementing, and varus position. No significant acetabular component wear was observed.
Conclusions:
- Müller total hip arthroplasty demonstrates a high rate of femoral component aseptic loosening in the long term.
- Acetabular component loosening shows a concerning increase over time, necessitating further investigation.
- Surgical factors like cementing technique and component positioning are critical for long-term implant survival.