Abstract: We previously reported our results at a minimum of three
and seven years after use of a porous-coated acetabular metal shell in a
consecutive series of 138 revision total hip arthroplasties. The current
report presents the longer-term outcomes of these procedures, at fifteen to
nineteen years postoperatively.
A total of twenty metal shells (14%) underwent repeat revision. Seven of
the repeat revisions were performed because of recurrent dislocation, seven
were done at the time of femoral revision surgery, and six were done because
of infection. Nineteen of the revised shells were well fixed, and one was
aseptically loose. Of the sixty-seven hips in which the acetabular component
survived for more than fifteen years after the index operation, two (3%)
required a change of the modular acetabular liner because of wear or
osteolysis. Nine (16%) of the fifty-seven hips with at least fifteen years of
radiographic follow-up had an osteolytic lesion of >1 cm in diameter. The
fifteen-year survival rate of the metal shells, with failure defined as
revision because of loosening or as radiographic evidence of loosening, was
97%.
Revision total hip arthroplasty with this cementless acetabular component
has been followed by excellent component survivorship at fifteen years; the
most common reasons for repeat revision were recurrent dislocation and
infection.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.