10-year results of the uncemented Allofit press-fit cup in young patients

Abstract

Background and purposeUncemented acetabular components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the second decade in young and active patients. We report on a minimum 10-year follow-up of an uncemented press-fit acetabular component that is still in clinical use.MethodsWe examined the clinical and radiographic results of our first 121 consecutive cementless THAs using a cementless, grit-blasted, non-porous, titanium alloy press-fit cup (Allofit; Zimmer Inc., Warsaw, IN) without additional screw fixation in 116 patients. Mean age at surgery was 51 (21–60) years. Mean time of follow-up evaluation was 11 (10–12) years.ResultsAt final follow-up, 8 patients had died (8 hips), and 1 patient (1 hip) was lost to follow-up. 3 hips in 3 patients had undergone acetabular revision, 2 for deep infection and 1 for aseptic acetabular loosening. There were no impending revisions at the most recent follow-up. We did not detect periacetabular osteolysis or loosening on plain radiographs in those hips that were evaluated radiographically (n = 90; 83% of the hips available at a minimum of 10 years). Kaplan-Meier survival analysis using revision of the acetabular component for any reason (including isolated inlay revisions) as endpoint estimated the 11-year survival rate at 98% (95% CI: 92–99).InterpretationUncemented acetabular fixation using the Allofit press-fit cup without additional screws was excellent into early in the second decade in this young and active patient cohort. The rate of complications related to the liner and to osteolysis was low.

Early Migration Predicts Aseptic Loosening of Cementless Femoral Stems: A Long-term Study

“…However, prediction of longterm implant performance is difficult and definitive results regarding aseptic loosening are available only after lengthy followup [24,32,33]. Widespread use of poor-performing implants might occur before these results are available [7,8].…”

Systematic review: lack of evidence for the success of revision arthroplasty outcome in younger patients

“…After its re-introduction in the 1990s, the resurfacing prosthesis became quite popular, especially for use in the younger patient, and this could have impacted the number of cohorts of younger patients receiving THA. An additional explanation for our findings could be that collecting data such as primary-and subsequent revision arthroplasty outcomes requires strict and intensive follow-up of young patients, as also suggested by others (8)(9)(10)(11). As revisions are often performed in specialised referral centres, practice can lead to mixed cohorts, or a number of patients lost to follow-up.…”

Acetabular Subchondral Bone Decortication and Its Role in the Outcome of Cemented Total Hip Replacement in Young Patients

“…Other authors have reported a high rate of revision due to problems occurring at the liner-metal shell couple21,22). Similar observations are echoed in reports from other national joint registries232425). Hence, questions prevail on whether uncemented acetabular components in primary THRs are the panacea for long-term survival in young and active patients.…”