Ten-year follow-up of an anatomical hydroxyapatite-coated total hip prosthesis

We report our results after ten year follow-up of 107 consecutive ABG-I hip prostheses implanted between June 1990 and December 1992: Only 84 prostheses were still in the study after ten years, but only six patients had undergone surgical revision. We can consider our clinical outcomes as excellent, with a whole-implant survival rate greater than 96%, a mean Merle D’Aubigne and Postel score increasing from 7.97 before operation to 16.17 at ten year follow-up, and a personal subjective assessment as excellent or good in 82.14% of patients. However, radiographic outcomes are more worrying: around 90% of patients show a stress-shielding phenomenon and granulomatous lesions in the proximal femur, and more than 82% suffer polyethylene wear greater than one  millimetre (mean 1.68 mm). We think that zirconia stem heads and hooded antiluxation PE inserts are determining factors in the process of PE wear and, secondarily, in cancellous bone resorption and bone osteolysis.