| BACKGROUND: So-called second-generation cementing techniques in total hiparthroplasty have been shown to provide better survival of the femoral component thanfirst-generation methods do; however, surface finish and other features of the component design alsoinfluence the durability of the reconstruction. The purpose of this study was to determine theresults of primary total hip replacement with use of a collared femoral component with amatte-finished surface fixed with second-generation cementing techniques and followed for ten totwenty years. METHODS: The study group consisted of 256 consecutive hips in 236 patients who had hada primary total hip arthroplasty with fixation of a Harris Design-2 femoral component withsecond-generation cementing techniques (use of an intramedullary plug and a cement gun). The meanage of the patients at the time of the operation was sixty-six years. One hundred and twelvepatients were male, and 124 were female. Seven patients were lost to follow-up less than ten yearsafter the operation. The median duration of follow-up of the living patients who had not had arevision was 15.4 years. RESULTS: At the time of the most recent follow-up, nineteen femoralcomponents (7%) had been revised because of aseptic loosening, five (2%) had been removed because ofdeep infection, and one (0.4%) had been revised because of recurrent dislocation. The mean Harriship score for the surviving patients who had not had a revision improved from 51 pointspreoperatively to 91 points at the most recent evaluation. At fifteen years, the estimated survivalrate of the femoral components was 92.2% with revision due to aseptic loosening as the end point and90.1% with mechanical failure (radiographic loosening or revision due to aseptic loosening) as theend point. Patients who were younger than fifty years old at the time of the operation had a lowerfifteen-year rate of survival of the femoral implant, in terms of both revision due to asepticloosening (72.3% compared with 95.7%, p = 0.0001) and mechanical failure (72.3% compared with 93.1%,p = 0.005), than did patients who were fifty years or older. CONCLUSIONS: Fixation of this collaredmatte-finished femoral component with use of second-generation cementing techniques for primarytotal hip replacement provided satisfactory results at ten to twenty years in older patients butless satisfactory results in younger patients |
