Clin Orthop Surg.  2022 Sep;14(3):335-343. 10.4055/cios21176.

Average 22-Year Results of Total Hip Arthroplasty Using Harris-Galante Prosthesis in Patients under 50 Years

Affiliations
  • 1Department of Orthopedic Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • 2Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
  • 3Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea
  • 4Department of Medical Statistics, Kyungpook National University, Daegu, Korea
  • 5Department of Biomedical Engineering, College of Medical Science, Catholic University of Daegu, Gyeongsan, Korea

Abstract

Background
The Harris-Galante (HG) prosthesis is a first-generation, cementless total hip arthroplasty (THA) prosthesis. Considering the recent increase in the demand for THA in young patients and their life expectancy, a study with a follow-up duration of longer than 20 years in a young population is needed. Therefore, we evaluated the long-term clinical and radiographic results after cementless THA using the HG prosthesis in patients younger than 50 years.
Methods
A total of 61 THAs performed using the HG with a minimum follow-up of 10 years were included. There were 38 men and 11 women with an average age of 46 years and the mean follow-up duration was 22 years. Clinical evaluation included modified Harris Hip Score (HHS) and radiographic analysis consisted of cup inclination, anteversion angle, component stability, osteolysis, liner wear rate, wear-through, liner dissociation, and heterotopic ossification. Complications included recurrent dislocation, periprosthetic femoral fracture, and periprosthetic joint infection. Survivorship analysis included cup and stem revision for aseptic loosening, as well as any revision.
Results
The HHS improved from 46.5 preoperatively to 81.8 postoperatively (p < 0.001). The average linear wear rate was 0.36 mm/yr. A total of 34 hips (56%) were revised: stem revision in 10 (16.4%), cup revision in 9 (14.8%), exchange limited to bearing surface in 8 (13.1%), and revision of all components in 7 (11.5%). Estimated survivorship at 34 years postoperatively was 90.9% for cup revision for aseptic loosening, 80.5% for stem revision for aseptic loosening, and 22.1% for any revision.
Conclusions
THA using the HG prosthesis showed satisfactory estimated survivorship of the acetabular and femoral components at 34 years postoperatively with good clinical outcomes. Bearing-related problems, such as osteolysis and liner dissociation, accounted for 56% of revision operations and were concerns in patients younger than 50 years.

Keyword

Cementless total hip arthroplasty; Harris-Galante prosthesis; Liner dissociation; Osteolysis; Outcome
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