Objective: The aim of this study was to evaluate theclinical, radiological, and survivorship results of a porous-coated uncementedacetabularcup (Novation Crowncup TM Exactech, Gainesville, Florida, USA) in patientsundergoing total hip arthroplasty at themid to long term follow-up.Methods: We prospectively analyzed 185 consecutivetotal hip replacements in 176 patients during 2009. All the patients receivedaNovation Crowncup™ uncemented cup. All surgeries were performed by one ofthe 4 joint replacement specialists. Severalclinical and radiographic outcomemeasures were evaluated.Results: There was no cupmigration recorded. Six cups (5.2%) had a thin (less than 1 mm) radiolucentline without signs ofloosening or clinical manifestation, but under close followup. The wear was not significative at the end of the follow up. Themean HarrisHip Score increased from 45.7 (range = 28 to 65) preoperatively to 89.8 (range= 87 to 96) at the final follow-up.Subjectiveevaluation showed excellent results in 82.6%, good in 8.6%, fair in 5.9%, andpoor in 2.9% of the cases. Eight patients, 3stems, and 5 cups (5% of the series)were revised, the survival of the series was 95% when the failure was the needfor additionalacetabular or femoral revision surgery for any reason. If wedefine failure as the need for an acetabular revision for some reason,thesurvival was (97.5%). When we evaluated survival only for aseptic loosening ofthe cup at 10 years of follow-up, 98.4% of theimplants survived.Conclusion: In our series,when we evaluated survival only for aseptic loosening of the cup at 10 years offollow-up, 98.4% of theimplants survived. The Crowncup acetabular cup survivalrate was 97.5% including all causes of loosening and 95% including allcausesfor revision at 10 years of follow-up.Level of Evidence: Level IV, Therapeutic Study
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1. Havelin LI, Espehaug B, Engesaeter LB. The performance of two hydroxyapatite-coated acetabular cups compared with Charnley cups. From the Norwegian Arthroplasty Register. J Bone Joint Surg Br. 2002;84-B(6):839- 845. 10.1302/0301-620X.84B6.0840839
2. Shon WY, Park B-Y RRN, Park PS, Im JT, Yun HH. Total hip arthroplasty: Past, present, and future. what has been achieved? Hip Pelvis. 2019;31(4):179-189. 10.5371/hp.2019.31.4.179
3. Kindsfater K, Lesko J. Survivorship of a modular acetabular cup system: Medium- to long-term follow-up. Arthroplasty Today. 2018;4(3):376-382. 10. 1016/j.artd.2017.07.001
4. McLawhorn AS, Potter HG, Cross MB, et al. Posterior Soft Tissue Repair After Primary THA is Durable at Mid-term Followup: A Prospective MRI Study. Clin Orthop Relat Res. 2015;473(10):3183-3189. 10.1007/s11999-015-4380-0
5. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stemtype femoral components: A radiographic analysis of loosening. Clin Orthop Relat Res. 1979;(141):17-27 .47710010.1007/978-1-4471-5451-8_8
6. Loudon JR, Charnley J. Subsidence of the femoral prosthesis in total hip replacement in relation to the design of the stem. J Bone Joint Surg Br. 1980;62-B(4):450-453. 10.1302/0301-620X.62B4.7430222
7. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;(121):20-32 .99150410.1097/ 00003086-197611000-00003
8. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217- 220. 10.2106/00004623-197860020-00014
9. Barrack RL, Mulroy RD, Harris WH. Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review. J Bone Joint Surg Br. 1992;74-B(3):385-389. 10. 1302/0301-620X.74B3.1587883
10. Brooker AF, Bowerman JW, Robinson RA, Riley LH. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973;55(8):1629-1632. 10.2106/00004623-197355080-00006
11. Martell JM, Berdia S. Determination of polyethylene wear in total hip replacements with use of digital radiographs. J Bone Joint Surg Am. 1997;79(11):1635- 1641. 10.2106/00004623-199711000-00004
12. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):73755.15. ):73755.15. 10.2106/00004623-196951040-00012
13. Mäkelä KT, Eskelinen A, Pulkkinen P, Paavolainen P, Remes V. Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry. J Bone Joint Surg Am. 2008;90(10):2160-2170. 10.2106/JBJS.G.00870
14. Clohisy JC, Harris WH. The Harris-Galante uncemented femoral component in primary total hip replacement at 10 years. J Arthroplasty. 1999;14(8):915-917. 10.1016/S0883-5403(99)90003-7
15. Ritter MA, Thong AE. The role of cemented sockets in 2004: Is there one? J Arthroplasty. 2004;19( Suppl 4):92-94. 10.1016/j.arth.2004.02.006
16. Faizan A, Chuang P, Aponte C, Moretti V, Sharkey PF. Radiolucencies surrounding acetabular components with three-dimensional coatings: Artifact or real? Arthroplasty Today. 2017;3(4):269-274. 10.1016/j.artd.2017.06.004
17. Streit MR, Weiss S, Andreas F, et al. 10-year results of the uncemented Allofit press-fit cup in young patients. Acta Orthop. 2014;85(4):368-374. 10.3109/ 17453674.2014.925351
18. Long WJ, Nayyar S, Chen KK, Novikov D, Davidovitch RI, Vigdorchik JM. Early aseptic loosening of the Tritanium primary acetabular component with screw fixation. Arthroplasty Today. 2018;4(2):169-174. 10.1016/j.artd.2017.11.009
19. Bjerkholt H, Høvik Ø., Reikerås O. Direct comparison of polyethylene wear in cemented and uncemented acetabular cups. J Orthop Traumatol. 2010;11 (3):155-158. 10.1007/s10195-010-0104-0
20. Della Valle CJ, Mesko NW, Quigley L, Rosenberg AG, Jacobs JJ, Galante JO. Primary total hip arthroplasty with a porous-coated acetabular component. A concise follow-up, at a minimum of twenty years, of previous reports. J Bone Joint Surg (Am). 2009;91(5):1130-1135. 10.2106/JBJS.H.00168
21. Kim YH, Kim JS, Park JW, Joo JH. Periacetabular osteolysis is the problem in contemporary total hip arthroplasty in young patients. J Arthroplasty. 2012;27 (1):74-81. 10.1016/j.arth.2011.03.022
22. Zicat B, Engh CA, Gokcen E. Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg Am. 1995;77(3):432-439. 10.2106/00004623-199503000-00013
23. Barrack RL, Folgueras A, Munn B, Tvetden D, Sharkey P. Pelvic lysis and polyethylene wear at 5–8 years in an uncemented total hip. Clin Orthop. 1997;(335):211-217. 10.1097/00003086-199702000-00020
24. Udomkiat P, Dorr LD, Wan Z. Cementless hemispheric porous-coated sockets implanted with press-fit technique without screws: Average ten-year follow-up. J Bone Joint Surg Am. 2002;84-A(7):1195-1200. 10.2106/00004623-200207000- 00016
25. Ritter MA, Thong AE, Davis KE, Berend ME, Meding JB, Faris PM. Long-term deterioration of joint evaluation scores. J Bone Joint Surg Br. 2004;86-B(3):438- 442. 10.1302/0301-620X.86B3.14243
26. Celebi L, Muratli HH, Akşahin E, Yağmurlu MF, Yüksel HY, Biçimoğlu A. Femur başi avasküler nekrozu olan hastalarda çimentosuz total kalça artroplastisi [Cementless total hip arthroplasty in patients with avascular necrosis of the femoral head]. Acta Orthop Traumatol Turc. 2006;40(2): 105-110.16757925