One hundred and forty revisions for loosening of the acetabular
component were performed in 124 patients, with the use of an uncemented
Harris-Galante acetabular prosthesis. A component was considered loose if
there was a change in its position or vertical or horizontal migration, or
both, of four millimeters or more, as demonstrated on serial radiographs.
All patients were followed prospectively for a mean of forty-one months
(range, twenty-four to seventy-six months). Bone-grafting was performed at
the time of the revision in 127 of the hips. Identifiable failure of
fixation of the acetabular component occurred in only two hips (1 per
cent), which had both severe acetabular bone loss and pelvic discontinuity.
In one of these hips, fixation of the component could not be achieved
during the revision, and the component subsequently migrated. No other
components migrated. Only one patient had a revision of the index
acetabular operation. A continuous radiolucency developed at the bone-mesh
interface of five acetabular components, and in one other hip a small
portion of the mesh separated. This hip was reoperated on for a problem
with the femur, and the socket was found to be rigidly fixed. No other
evidence of loosening was identified. All of the bone grafts united, but
partial resorption of the graft occurred in thirty-nine hips. Although
there were substantial osseous defects that necessitated major
bone-grafting, revision with the uncemented Harris-Galante porous-coated
acetabular component provided superior fixation compared with that reported
in other series in which cemented acetabular components were used for
revision. Of the 140 hips, eighty-nine (64 per cent) had a postoperative
score of good or excellent, according to the Harris hip-rating system.
Twenty-eight (70 per cent) of the forty hips that had revision of the
acetabular component alone were rated as good or excellent.