Uncemented Harris-Galante total hip arthroplasty in patients with osteonecrosis of the femoral head. A 10-16-year follow-up study.

Background: There have only been a few reports regarding the long-term results of uncemented THAs in patients with osteonecrosis.

Patients And Methods: We evaluated the long-term results of 65 consecutive uncemented total hip arthroplasties (Harris-Galante type I prostheses) in 54 men (59 hips) and 5 women (6 hips) with osteonecrosis of the femoral head. The mean age was 53 (33-64) years. The mean duration of follow-up was 12.5 (10-16) years.

Results: 9 femoral stems and 3 acetabular metal shells were revised. 2 polyethylene liners were changed due to excessive wear. A girdlestone procedure was done in 2 patients (2 hips) due to delayed deep infection. The mean polyethylene wear was 0.14 mm per year. 3 non-revised hips had pelvic osteolysis and 18 had femoral osteolysis. The 15-year survival rates, using failure defined as the removal of any component for any reason, were 85 (95% CI; 79-91)% for the acetabular and 80 (74-86)% for the femoral component and 70 (63-77)% for any of the components.

Interpretation: The first generation of the HGP design was frequently associated with pain, unstable fixation, and osteolysis. Excessive wear was frequent. The cup showed better durability than the stem.