The results of eighty-three consecutive primary total hip arthroplasties
in which a Harris-Galante porous-coated acetabular component had been used
were reviewed after a minimum of five years. In all patients, the stated
diameter of the acetabular component (the diameter printed on the packaging
for the implant) used was equal to the stated diameter of the reamer (the
diameter printed on the reamer) that had been used last in the preparation
of the acetabulum. As there was little or no press-fit stability, stability
was obtained initially with multiple transfixing screws. No component was
revised because of loosening, and none were radiographically loose at an
average of sixty-eight months and a maximum of seven years after the
operation. There was no evidence of disruption of the titanium porous mesh,
and no screw had bent or broken. Two sockets, however, had been revised
because of failure of the liner-locking mechanism as well as disassociation
of the polyethylene liner from the titanium-alloy shell. Lysis of bone
occurred in only one patient, around one screw. Areas of non-contact (gaps)
between the porous mesh at the periphery of the acetabular component and
the bone were seen on the immediate postoperative radiographs of nearly
half of the patients. New areas of radiolucency, which had not been seen
immediately postoperatively, were identified at two years in forty-nine
hips. These radiolucent lines were never wider than one millimeter and were
most frequently located in zone 3 and, less frequently, in zone 1. At the
time of the most recent follow-up evaluation, a progressive radiolucent
line was identified around twenty-two components and a discontinuous
radiolucent line was present in all three zones around eleven components.
No continuous radiolucent line was identified at the mesh-bone interface of
any component. These results are superior to our results with cemented
acetabular components after a similar period of follow-up. A longer period
of follow-up is needed before the importance of these thin radiolucent
lines can be determined, but experience with cemented acetabular components
indicates that progressive or extensive radiolucent lines, or both, may
represent resorption of bone at the porous mesh-bone interface and this can
lead to loosening of the component. Our data suggest that the technique
used for implantation may be important not only for the initial fixation
and ingrowth of bone, but also for the long-term durability of the fixation
of a porous-coated acetabular component.(ABSTRACT TRUNCATED AT 400
WORDS)