Rationale of a flexible press fit cup in total hip replacement. 5-year followup in 280 procedures

A consecutive series of 280 total hip replacements in 261 patients using the Press Fit Cup with a minimum followup of 5 years is presented. The Press Fit Cup is a nonmodular acetabular component with a porous coating made of titanium fibers. It has one peg and is 1.5 mm oversized with biradial eccentricity. It has a flattened pole area, requires no screw fixation, and partially preserves elasticity. The mean age was 71 years for women, 70 years for men. Forty-seven patients (49 hips) died before the 5-year review, and five patients were unable to return for the followup because of physical infirmity. Two hundred eighteen patients (226 hips) were available for the clinical 5-year followup, and 208 patients (213 hips) were available for the radiographic followup. No intraoperative fracture of the acetabulum occurred; four hips dislocated; 94% clinically were rated as excellent or good. One hip in a patient with rheumatoid arthritis had to be revised for aseptic loosening of the cup and nine femoral stems had to be revised. No migration of the cup could be measured. There was no osteolysis seen around the cup. In six cases a radiolucent line was seen in Zone 1, and in eight hips in Zone 3. There was one hip with a continuous radiolucent line which was considered radiographically loose.