The Journal of Bone and Joint Surgery, Vol 64, Issue 5 745-748, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
Socket fixation using a metal-backed acetabular component for total hip replacement. A minimum five-year follow-up
WH Harris and RE White
We did a follow-up study on fifty-three total hip-replacement procedures in
forty-seven patients in whom a metal-backed acetabular component was used.
The minimum follow-up was five years (average, six and one-half years).
These relatively young patients ranged in age from seventeen to seventy-six
years old (average, forty-one years old). Excluding one septic hip and one
traumatic dislocation of the acetabular component, three sockets became
loose in the remaining fifty-one hips. The results in thirty-four patients
who were forty-five years old or younger were compared with those in a
group of patients of similar age, reported by Dorr and Takei, in whom
sockets without metal backing were used. Thirteen of the forty-three
non-metal-backed sockets in their patients became loose or had a continuous
radiolucent line at least two centimeters thick around the entire
circumference of the cement on an anteroposterior radiograph, which they
referred to as impending failure. In comparison, the three loose acetabular
components in our thirty-four patients comprised a statistically
significant reduction (p less than 0.05). No acetabular components in our
series showed evidence of impending failure. We and others have reported
finite-element analyses showing that a metal backing on the acetabular
component reduces peak stresses in the bone, cement, and polyethylene.
These analytical data are now supported by the clinical data reported here;
that is, the metal backing of the acetabular component enhanced the
duration of cement fixation.
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