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Cementless total hip arthroplasty with AML, PCA and HGP prostheses
1Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, Kangwon-Do, Republic of Korea.
International Orthopaedics
|January 1, 1995
Summary
This study compared three cementless hip prostheses (PCA, AML, HGP) over 2-8 years. Results showed similar clinical outcomes, though AML stems demonstrated greater bone ingrowth and no loosening.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Radiology
Background:
- Cementless hip prostheses are widely used in total hip arthroplasty.
- Evaluating the long-term performance and biological integration of different implant designs is crucial for patient outcomes.
- Porous-coated femoral stems and acetabular cups aim to promote bone ingrowth and long-term fixation.
Purpose of the Study:
- To compare the clinical and radiological outcomes of three different cementless hip prostheses: PCA (Porous-Coated Monatomic), AML (Monatomic Medullary Locking), and HGP (Harris-Galante-Porous).
- To assess the incidence of aseptic loosening, polyethylene wear, thigh pain, and radiological changes over a 2- to 8-year follow-up period.
- To evaluate the degree of bony ingrowth associated with each prosthesis type.
Main Methods:
- A retrospective study of 214 patients with 270 cementless hip prostheses (PCA, AML, HGP).
- Follow-up period ranged from 2 to 8 years.
- Clinical assessment using Harris hip scores and radiological evaluation for loosening, wear, migration, calcar remodelling, radiolucent lines, and bony ingrowth.
Main Results:
- Overall clinical results were comparable across the three prostheses, with average Harris hip scores of 93 (PCA), 93 (AML), and 91 (HGP).
- Four PCA prostheses showed radiological aseptic loosening, and one required revision due to polyethylene wear. No loosening was observed with AML and HGP prostheses.
- Thigh pain occurred in 17% (AML), 21% (PCA), and 19% (HGP) of cases. Radiological changes were similar at 5 years, but AML stems exhibited greater bony ingrowth.
Conclusions:
- PCA, AML, and HGP cementless hip prostheses demonstrate similar overall clinical performance and radiological findings in the medium term.
- AML femoral stems may offer superior bony ingrowth compared to PCA and HGP.
- While aseptic loosening was observed in PCA prostheses, AML and HGP showed no loosening, suggesting potential long-term stability advantages.