Extensively coated femoral components in young patients

A review of 174 hips in 154 patients younger than 50 years of age who underwent primary total hip arthroplasty with a cementless acetabular component and an extensively coated femoral component done by one surgeon was performed to determine whether this method of fixation improves the results of previously reported comparable series using different methods of fixation. The average age was 37.6 years. The average followup was 8.3 years (range, 2-13 years). Eighty-eight hips had at least 10 years followup. Sixteen (9%) hips had severe stress shielding. There were 13 (7.5%) acetabular failures. Of 144 porous coated cups, three were revised for wear and one for dislocation. Another was revised 11 years postoperatively for late loosening secondary to catastrophic acetabular lysis. Excluding the bipolar and threaded components (30 hips), five (3.4%) porous coated cups were revised for failure. Of the 174 fully coated stems, 99.4% had stable fixation, 167 (96%) were ingrown, six (3.4%) had stable fibrous fixation, and one (0.6%) was unstable. Two (1.1%) femoral stems were revised. The total rate of osteolysis was 4%. Cementless extensively porous coated stems and porous coated acetabuli give excellent lasting results in young patients.