Distribution of Periacetabular Osteolytic Lesions Varies According to Component Design

Using computed tomography, the volume, location, and number of osteolytic lesions were determined adjacent to 38 Harris-Galante 1 (HG-1) acetabular components fixed with screws and 19 porous-coated anatomic (PCA) acetabular components press-fitted without screws. The median implantation times were 16 and 15 years, respectively. The mean total lesion volumes were similar: 11.1 cm³ (range, 0.7-49 cm³) and 9.8 cm³ (range, 0.4-52 cm³), respectively, for hips with HG-1 and PCA components (P = .32). There was a significant difference in the proportion of rim-related, screw or screw hole–related, and combined lesions between the 2 component designs (P < .0001). HG-1 components had more screw and screw hole–related lesions, and PCA components had more rim-related lesions. Although there are concerns regarding screw and screw hole–associated osteolysis, these findings suggest that peripheral fixation may be well maintained in the long term with the use of multiple-hole acetabular components with screw fixation.