Uncemented Harris-Galante total hip arthroplasty in patients with osteonecrosis of the femoral head

摘要

Background?There have only been a few reports regarding the long-term results of uncemented THAs in patients with osteonecrosis. Patients and methods?We evaluated the long-term results of 65 consecutive uncemented total hip arthroplasties (Harris-Galante type I prostheses) in 54 men (59 hips) and 5 women (6 hips) with osteonecrosis of the femoral head. The mean age was 53 (33–64) years. The mean duration of follow-up was 12.5 (10–16) years. Results?9 femoral stems and 3 acetabular metal shells were revised. 2 polyethylene liners were changed due to excessive wear. A girdlestone procedure was done in 2 patients (2 hips) due to delayed deep infection. The mean polyethylene wear was 0.14?mm per year. 3 non-revised hips had pelvic osteolysis and 18 had femoral osteolysis. The 15-year survival rates, using failure defined as the removal of any component for any reason, were 85 (95% CI; 79–91)% for the acetabular and 80 (74–86)% for the femoral component and 70 (63–77)% for any of the components. Intepretation?The first generation of the HGP design was frequently associated with pain, unstable fixation, and osteolysis. Excessive wear was frequent. The cup showed better durability than the stem.