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Fifteen-Year Results of Cementless Total Hip Replacement

Total hip replacements (THRs) don't last forever. But how long do they last? Most doctors tell patients to expect about 15 years of good service. Some doctors are keeping track to find out the long-term results.

This report updates the results of an ongoing study. Doctors at the Walter Reed Army Medical Center in Washington, DC, started using cementless total hip replacements back in 1983. They've been keeping track of the results ever since.

Reports have been published after two, five, and 10 years. This is the 15-year report. Pain (hip or thigh), limp, and use of walking aids were used as measures of success or failure. Doctors also kept track of how many implants came loose and had to be revised.

At 10 years, 96 percent of the patients had no hip pain (or only slight pain). The same results were found at 15 years for 72 percent of cases. Decline in function was thought to be more a result of the aging process than the THR.

More than one-third of the implants loosened because of bone loss. Not all implants had to be revised. The implants that were revised showed quite a bit of wear when removed. The authors of this study suggest that the durability of the early cementless implants was the long-term problem in their series.

They conclude that today's cementless THR are of better quality. With improved surgical techniques, cementless THR will continue to be a good choice. Better, more durable results can be expected in future studies.

References: J. A. Boiescul, MD, et al. Results of Porous-Coated Anatomic Total Hip Arthroplasty without Cement at Fifteen Years. In The Journal of Bone and Joint Surgery. June 2003. Vol. 85-A. No. 6. Pp. 1079-1083.

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