Cemented THA may yield good long-term outcomes in middle-aged patients

de Kam, DC. Acta Orthop. 2010 Apr;81(2):165-170.

Performing a cemented total hip arthroplasty in patients between the ages of 40 and 50 years and incorporating impacted bone grafts with a cemented cup in those with acetabular deficiencies may improve clinical scores and lead to good long-term survivorship, according to a study conducted by investigators from the Netherlands.

“Cemented implants in young patients have satisfying long-term results,” Daniël C J de Kam, MD, and colleagues wrote in their study abstract. “Reconstruction of acetabular deficiencies with impacted bone grafts show promising results.”

For their study, de Kam and his colleagues evaluated the results of 140 patients (168 hips) who underwent cemented total hip arthroplasty at a single institution. Of these cases, 70 hips had acetabular deficiencies that surgeons reconstructed using wire meshes and impacted bone grafts with a cemented cup. Overall, the study group had a mean age of 46 years at the time of surgery and had a mean follow-up of 10 years.

Eight-teen patients died due to unrelated causes during the follow-up period, according to the abstract. Of these, three patients (three hips) underwent a revision.

The investigators evaluated the results of the remaining living patients using radiographs and several outcome measures including a Visual Analog Scale measuring pain at rest and during physical activity, the Harris Hip Score, Oxford hip score and a 100-point patient satisfaction score.

The investigators discovered that all of the clinical hip scores improved. In addition, they found that 29 hips underwent a revision after a mean follow-up of 8 years. Using revision of either component for any reason, the investigators discovered an 88% survivorship after 10 years. The Kaplan-Meier survival analysis also revealed a 94% survivorship after 10 years using revision of either component for aseptic loosening as an endpoint.