The Journal of Bone and Joint Surgery, Vol 76, Issue 2 195-201, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Hip replacement with a threaded acetabular cup. A follow-up study
GM Fox, AA McBeath and JP Heiner
University of Wisconsin Hospital and Clinics, Madison.
A study was begun in 1983 to determine the efficacy of a threaded
acetabular cup. Fifty-five patients who had a total of sixty-eight threaded
titanium cups had a complete clinical and radiographic evaluation yearly.
Fifty-two of the arthroplasties had been primary and sixteen, revisions.
The average duration of follow-up was six years (range, five to nine
years). Seventeen cups had to be revised at an average of sixty-two months
(range, twenty-seven to 108 months) after the index operation. Nine
additional cups were loose and revision was pending at the most recent
follow-up examination. Failure was defined as revision or pending revision.
Thus, twenty-six (38 per cent) of the sixty-eight cups failed. Sixteen (31
per cent) of the fifty-two primary arthroplasties failed and ten of the
sixteen revision arthroplasties failed. Radiographic changes that were
evident in patients who had a failed cup consisted of superomedial
migration of the cup with osteolysis in Zone 3, as classified by DeLee and
Charnley. These radiographic changes preceded symptoms in most patients.
Because of the high rate of failure of this acetabular component at six
years, we believe that its use is not warranted.