The Journal of Bone and Joint Surgery (American). 2005;87:1795-1800.
doi:10.2106/JBJS.D.01818
© 2005 The Journal of Bone and Joint Surgery, Inc.
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 Adult Hip Reconstruction Test 16: Fall 2005
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Revision of the Acetabular Component without Cement After Total Hip Arthroplasty

A Concise Follow-up, at Fifteen to Nineteen Years, of a Previous Report*

Craig J. Della Valle, MD1, Tasin Shuaipaj, BA1, Richard A. Berger, MD1, Aaron G. Rosenberg, MD1, Susan Shott, PhD1, Joshua J. Jacobs, MD1 and Jorge O. Galante, MD1

1 Department of Orthopaedic Surgery, Rush University Medical Center, Professional Building, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612. E-mail address for C.J. Della Valle: craigdv{at}yahoo.com

Investigation performed at the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Zimmer. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Zimmer). Also, a commercial entity (Zimmer) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

* Original Publications Padgett DE, Kull L, Rosenberg A, Sumner DR, Galante JO. Revision of the acetabular component without cement after total hip arthroplasty. Three to six-year follow-up. J Bone Joint Surg Am. 1993;75:663-73.

Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO. Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am. 1996;78:1366-70.

Abstract: We previously reported our results at a minimum of three and seven years after use of a porous-coated acetabular metal shell in a consecutive series of 138 revision total hip arthroplasties. The current report presents the longer-term outcomes of these procedures, at fifteen to nineteen years postoperatively.

A total of twenty metal shells (14%) underwent repeat revision. Seven of the repeat revisions were performed because of recurrent dislocation, seven were done at the time of femoral revision surgery, and six were done because of infection. Nineteen of the revised shells were well fixed, and one was aseptically loose. Of the sixty-seven hips in which the acetabular component survived for more than fifteen years after the index operation, two (3%) required a change of the modular acetabular liner because of wear or osteolysis. Nine (16%) of the fifty-seven hips with at least fifteen years of radiographic follow-up had an osteolytic lesion of >1 cm in diameter. The fifteen-year survival rate of the metal shells, with failure defined as revision because of loosening or as radiographic evidence of loosening, was 97%.

Revision total hip arthroplasty with this cementless acetabular component has been followed by excellent component survivorship at fifteen years; the most common reasons for repeat revision were recurrent dislocation and infection.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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