Skip to main content
The Iowa Orthopaedic Journal logoLink to The Iowa Orthopaedic Journal
. 1995;15:43–47.

Primary cemented total hip arthroplasty: five to twelve year clinical and radiographic follow-up.

I Hirose 1, W N Capello 1, J R Feinberg 1, R M Shirer 1
PMCID: PMC2329078  PMID: 7634044

Abstract

A retrospective clinical and roentgenographic study was completed on 131 primary cemented total hip arthroplasties with a minimum of five years follow-up (mean, seven years; range, five to twelve years). Second generation cement technique including plugging of the medullary canal, cement gun filling, and pressurization of the canal was used. Acetabular cement was also pressurized. The total mechanical failure rate of the acetabular components was 18.4% compared to that of the femoral components which was 3.1%. There was a significantly higher incidence of acetabular component failure in rheumatoid arthritis patients (38.9%) compared to a preoperative diagnosis of primary osteoarthritis (14.1%) (p = 0.013). Yet there were no rheumatoid arthritis patients in the femoral component revision group. There were no differences in revision rates for metal-backed versus nonmetal-backed cups (p = 0.113). The average thickness of the proximal medial cement mantle was 2.8 millimeters in the loosening group and 5.4 millimeters in the nonloosening group (p = 0.333). All failures occurred in those patients whose proximal medial cement mantle was less than five millimeters. The authors strongly endorse the use of hybrid total hip arthroplasty and emphasize the need for meticulous surgical technique especially in obtaining a cement mantle of sufficient thickness in the proximal medial aspect of the femur.

Full text

PDF
43

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amstutz H. C. Arthroplasty of the hip. The search for durable component fixation. Clin Orthop Relat Res. 1985 Nov;(200):343–361. [PubMed] [Google Scholar]
  2. Beckenbaugh R. D., Ilstrup D. M. Total hip arthroplasty. J Bone Joint Surg Am. 1978 Apr;60(3):306–313. [PubMed] [Google Scholar]
  3. Carter D. R., Vasu R., Harris W. H. Stress distributions in the acetabular region--II. Effects of cement thickness and metal backing of the total hip acetabular component. J Biomech. 1982;15(3):165–170. doi: 10.1016/0021-9290(82)90248-2. [DOI] [PubMed] [Google Scholar]
  4. Cracchiolo A., 3rd, Severt R., Moreland J. Uncemented total hip arthroplasty in rheumatoid arthritis diseases. A two- to six-year follow-up study. Clin Orthop Relat Res. 1992 Apr;(277):166–174. [PubMed] [Google Scholar]
  5. Ebramzadeh E., Sarmiento A., McKellop H. A., Llinas A., Gogan W. The cement mantle in total hip arthroplasty. Analysis of long-term radiographic results. J Bone Joint Surg Am. 1994 Jan;76(1):77–87. doi: 10.2106/00004623-199401000-00010. [DOI] [PubMed] [Google Scholar]
  6. Gruen T. A., McNeice G. M., Amstutz H. C. "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979 Jun;(141):17–27. [PubMed] [Google Scholar]
  7. Harris W. H. Advances in total hip arthroplasty. The metal-backed acetabular component. Clin Orthop Relat Res. 1984 Mar;(183):4–11. [PubMed] [Google Scholar]
  8. Harris W. H., McCarthy J. C., Jr, O'Neill D. A. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am. 1982 Sep;64(7):1063–1067. [PubMed] [Google Scholar]
  9. Harris W. H., McGann W. A. Loosening of the femoral component after use of the medullary-plug cementing technique. Follow-up note with a minimum five-year follow-up. J Bone Joint Surg Am. 1986 Sep;68(7):1064–1066. [PubMed] [Google Scholar]
  10. Johnston R. C., Fitzgerald R. H., Jr, Harris W. H., Poss R., Müller M. E., Sledge C. B. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg Am. 1990 Feb;72(2):161–168. [PubMed] [Google Scholar]
  11. Mulroy R. D., Jr, Harris W. H. The effect of improved cementing techniques on component loosening in total hip replacement. An 11-year radiographic review. J Bone Joint Surg Br. 1990 Sep;72(5):757–760. doi: 10.1302/0301-620X.72B5.2211749. [DOI] [PubMed] [Google Scholar]
  12. Oh I., Bourne R. B., Harris W. H. The femoral cement compactor. An improvement in cementing technique in total hip replacement. J Bone Joint Surg Am. 1983 Dec;65(9):1335–1338. [PubMed] [Google Scholar]
  13. Oh I., Carlson C. E., Tomford W. W., Harris W. H. Improved fixation of the femoral component after total hip replacement using a methacrylate intramedullary plug. J Bone Joint Surg Am. 1978 Jul;60(5):608–613. [PubMed] [Google Scholar]
  14. Ritter M. A., Keating E. M., Faris P. M., Brugo G. Metal-backed acetabular cups in total hip arthroplasty. J Bone Joint Surg Am. 1990 Jun;72(5):672–677. [PubMed] [Google Scholar]
  15. Sarmiento A., Gruen T. A. Radiographic analysis of a low-modulus titanium-alloy femoral total hip component. Two to six-year follow-up. J Bone Joint Surg Am. 1985 Jan;67(1):48–56. [PubMed] [Google Scholar]
  16. Severt R., Wood R., Cracchiolo A., 3rd, Amstutz H. C. Long-term follow-up of cemented total hip arthroplasty in rheumatoid arthritis. Clin Orthop Relat Res. 1991 Apr;(265):137–145. [PubMed] [Google Scholar]
  17. Vasu R., Carter D. R., Harris W. H. Stress distributions in the acetabular region--I. Before and after total joint replacement. J Biomech. 1982;15(3):155–164. doi: 10.1016/0021-9290(82)90247-0. [DOI] [PubMed] [Google Scholar]
  18. Weinstein A. M., Bingham D. N., Sauer B. W., Lunceford E. M. The effect of high pressure insertion and antibiotic inclusions upon the mechanical properties of polymethylmethacrylate. Clin Orthop Relat Res. 1976 Nov-Dec;(121):67–73. [PubMed] [Google Scholar]

Articles from The Iowa Orthopaedic Journal are provided here courtesy of The University of Iowa

RESOURCES