The Journal of Bone and Joint Surgery (American). 2009;91:1130-1135.
doi:10.2106/JBJS.H.00168
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Primary Total Hip Arthroplasty with a Porous-Coated Acetabular Component

A Concise Follow-up, at a Minimum of Twenty Years, of Previous Reports*

Craig J. Della Valle, MD1, Nathan W. Mesko, MD1, Laura Quigley, MS1, Aaron G. Rosenberg, MD1, Joshua J. Jacobs, MD1 and Jorge O. Galante, MD1

1 Department of Orthopaedic Surgery, Rush University Medical Center, 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

* Original Publications

Tompkins GS, Jacobs JJ, Kull LR, Rosenberg AG, Galante JO. Primary total hip arthroplasty with a porous-coated acetabular component. Seven-to-ten-year results. J Bone Joint Surg Am. 1997;79:169-76.

Della Valle CJ, Berger RA, Shott S, Rosenberg AG, Jacobs JJ, Quigley L, Galante JO. Primary total hip arthroplasty with a porous-coated acetabular component. A concise follow-up of a previous report. J Bone Joint Surg Am. 2004;86:1217-22.

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Zimmer. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Zimmer). Also, a commercial entity (Zimmer) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

Abstract: We previously reported the seven and fifteen-year results of the use of a porous-coated acetabular metal shell inserted without cement in a consecutive series of 204 primary total hip arthroplasties. In the present study, we evaluated the longer-term outcomes of these arthroplasties at a minimum follow-up time of twenty years. One hundred and fourteen (92%) of the 124 hips available for study had retained the original acetabular metal shell. A total of five acetabular components had been revised for aseptic loosening or had radiographic evidence of definite loosening. Fourteen hips with well-fixed acetabular shells required a change of the modular acetabular liner because of excessive wear and/or for the treatment of osteolysis, and liner changes have been recommended for another eight hips. The twenty-year rate of survival of the metal shell, with failure defined as revision because of loosening or radiographic evidence of loosening, was 96% (95% confidence interval, 94% to 98%). Cementless acetabular reconstruction continues to provide durable fixation at twenty years postoperatively. Wear-related complications continue to be the major mode of failure.

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


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Letters to the Editor:

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Primary Total Hip Arthroplasty with a Porous-Coated Acetabular Component: Outcome in young patients?
B. Willem Schreurs, MD, PhD, et al.
JBJS Online, 30 Jun 2009 [Full text]
Dr. Della Valle and colleagues respond to Drs. Schreurs and de Kam
Craig J. Della Valle, MD, et al.
JBJS Online, 30 Jun 2009 [Full text]
Definition of Failure
Michael R. Whitehouse, MBChB, BSc, M(ScOrthEng), MRCS(Eng), et al.
JBJS Online, 5 Aug 2009 [Full text]
Dr. Della Valle and colleagues respond to Mr. Whitehouse and Mr. Bannister
Craig J. Della Valle, MD, et al.
JBJS Online, 5 Aug 2009 [Full text]