Cementless Acetabular Revision with the Harris-Galante Porous Prosthesis

Background: Revisions of the acetabular component of a total hip arthroplasty have a higher rate of complications, particularly loosening and dislocation, than do primary procedures. The purpose of this study, in which the results of a consecutive series of revisions performed with the Harris-Galante Porous acetabular component by a single surgeon were evaluated at an average of twelve years, was to quantify the complications and outcomes of acetabular revision.

Methods: Clinical and radiographic results were evaluated to assess loosening, lysis, radiolucencies, and trochanteric union in 188 hips (170 patients) treated between 1984 and 1990. One hundred and twenty-two hips in 110 patients were followed for at least ten years, which was required for inclusion in the study. Thirty-one patients (thirty-six hips) died less than ten years postoperatively, and twenty-nine patients (thirty hips) were lost to or refused to return for follow-up.

Results: The average Harris hip score was 78 points at an average of 12.5 years after revision, which was a 29-point improvement compared with the preoperative score. The rate of repeat revision because of aseptic loosening of the acetabular shell was 4% (five of 122). The rate of repeat revision of the shell for any reason was 15% (eighteen of 122). Eight unrevised sockets were loose radiographically, for a total rate of aseptic loosening of 11% (thirteen of 122).

Conclusions: This study demonstrated that most acetabular revisions with this cementless hemispherical socket were successful. Few structural grafts and no cages were used.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.