Total articular resurfacing arthroplasty with the Tara device was
performed on sixty-seven hips in sixty-three patients from 1978 to 1981. I
analyzed the results, paying particular attention to prosthetic failure.
Loosening of the femoral component occurred in one hip and loosening of the
acetabular component, in seven hips. All eight required revision to
conventional total hip replacement. Fifteen other patients in the series
had radiographic evidence of component failure but have had no significant
pain to date. They were regarded as having impending failure. Four of the
fifteen showed significant stress-shielding on the femoral side, two with
simultaneous acetabular lucency at the bone-cement interface. The other
eleven showed progressive acetabular lucency. The total anticipated failure
rate was 34.3 per cent (11.9 per cent definite and 22.4 per cent
anticipated). The ages of the patients at surgery averaged 49.1 years in
the actual failure group and 34.2 years in the impending failure group.
Factors that may have been responsible for the unacceptably high incidence
of component failure include the young age of the patients in whom this
operation was performed and their high activity level. Additional reasons
for mechanical failure (both definite and anticipated) on the acetabular
side include poor cement distribution with resultant micromotion and
increased frictional torque with the larger-diameter component of the
prosthesis.