Hybrid total hip replacement: Outcome after a mean follow up of 10 years

Background: Total hip replacement is one of the most successful surgical procedures of the modern surgical era. The method of fixation of implants continues to evolve, and as cemented acetabular fixation appears to be less durable than anticipated, the use of a cemented stem and an uncemented acetabulum - a so-called 'hybrid hip' - has become more popular. This paper reports the results of hybrid total hip replacement at an average of 10 years postoperatively. Methods: Primary hybrid total hip replacements carried out by a single surgeon in 1994 and 1995 were identified; patients were sent Oxford Hip Score and EuroQuol-5 Dimension quality-of-life questionnaires and, where necessary, a radiograph appointment. Questions about diabetes, cigarette smoking and hip dislocation were included. First postoperative and final radiographs were compared for stem subsidence, cup migration, stem position, osteolysis of the femur and pelvis, and evidence of loosening of both components. Results: At 10-year follow up the revision rate for femoral component loosening was 2.9%. Fifteen per cent showed some abnormality at the femoral interface, not related to stem size and more common in titanium stems. Average hip score was 20.9, and quality-of-life measures indicated a high level of satisfaction. Conclusions: Hybrid total hip replacement gives excellent clinical outcomes with low revision rates for both components. The one-piece uncemented cup offers important advantages over modular devices, the use of which should be re-evaluated.