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 Adult Hip Reconstruction Test 1: Primary Total Hip Arthroplasty
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The Journal of Bone and Joint Surgery (American) 85:296-303 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Total Hip Arthroplasty with Use of the Cementless Zweymüller Alloclassic System

A Ten to Thirteen-Year Follow-up Study

Eduardo Garcia-Cimbrelo, MD, Ana Cruz-Pardos, MD, Rosario Madero, MS and Miguel Ortega-Andreu, MD

Investigation performed at the Department of Orthopaedics and the Section of Biostatistics, Hospital "La Paz," Madrid, Spain

Eduardo Garcia-Cimbrelo, MD
Pez Austral 13, 5°A, 28007 Madrid, Spain. E-mail address: gcimbrelo{at}yahoo.es

Ana Cruz-Pardos, MD
Rosario Madero, MS
Miguel Ortega-Andreu, MDDepartment of Orthopaedics (A.C.-P. and M.O.-A.) and Section of Biostatistics (R.M.), Hospital "La Paz," Paseo de la Castellana 261, 28046 Madrid, Spain

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The Zweymüller Alloclassic total hip arthroplasty system is widely used, although few intermediate-term studies have been published. The purpose of the present study was to evaluate the clinical and radiographic results of this system after ten years.

Methods: One hundred and twenty-four consecutive primary total hip arthroplasties were performed with the Zweymüller Alloclassic cementless system at our institution between February 1988 and March 1991, and 104 hips (ninety-four patients) were retrospectively reviewed after a minimum duration of follow-up of ten years. The mean age of the patients at the time of the arthroplasty was 62.3 years (range, twenty-five to seventy-seven years). The mean duration of follow-up was 11.3 years. Standard radiographs were made for all patients immediately after the operation, at six and twelve months, and annually thereafter for at least ten years. Cox multivariate regression analysis was performed to assess the influence of various factors on survival of the implant.

Results: The cumulative probability of not having a revision of any prosthetic component for any reason was 94.1% (95% confidence interval, 91.9% to 96.3%) at twelve years in the best-case scenario and 85.3% (95% confidence interval, 82.1% to 88.5%) at twelve years in the worst-case scenario for the entire series of 124 hips. Among the 104 hips in the follow-up study, three acetabular components and no stems were revised. Two hips had level-4 pain according to the system of Merle D'Aubigné and Postel. Seven acetabular components (7%) were loose at twelve years, and all stems had radiographic evidence of stable fixation. Acetabular cup loosening was related to a vertical cup angle (p = 0.0008, Student t test), acetabular wear of >=1 mm (p = 0.001, Fisher exact test), and a 32-mm femoral head (p = 0.001, Fisher exact test). Although femoral osteolysis was seen in eighteen hips (17%) at twelve years, all osteolytic cavities were proximal and focal.

Conclusions: The Zweymüller Alloclassic prosthesis, particularly its femoral stem, demonstrated good results and durable fixation at a minimum of ten years of follow-up.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.



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