Fifty uncemented porous-coated total hip prostheses were implanted in
forty-seven patients whose mean age was fifty-eight years. Clinical
hip-rating scores, as described by Harris, were determined and
anteroposterior and frog-leg lateral radiographs were made preoperatively,
shortly postoperatively, and at three months, six months, one year, and two
years postoperatively. The mean hip-rating score was 92 points (range,
(range, 74 to 100 points) at one year and 92 points (range, 69 to 100
points) at two years. The thigh was slightly painful in nine patients (18
per cent) at one year and in eight (16 per cent) at two years. Fourteen
hips (28 per cent) (in thirteen patients) caused a moderate or severe limp
two years postoperatively; however, this complication appears to have been
related more to the direct lateral approach that was used than to the
prosthesis. Six (13 per cent) of the patients walked with a cane at one
year and five (11 per cent) still required a cane at two years. Serial
radiographic evaluations revealed that, between the first and second
postoperative years, a progressive radiodense femoral line developed in
twenty hips (41 per cent); a progressive acetabular line, in four hips (8
per cent); and progressive femoral sclerosis, in twelve hips (24 per cent).
There was progressive loosening of beads from twelve (24 per cent) of the
femoral components and from nine (18 per cent) of the acetabular
components. The position of one acetabular and one femoral component
changed. Two femoral shafts fractured, one intraoperatively and one
fourteen months postoperatively. We concluded that the clinical results
were encouraging in these patients at the end of two years. We are
concerned, however, about the progressive radiodense lines, sclerosis, and
loosening of beads as well as the slight, but persistent, pain in the thigh
in eight patients.