Revision of the acetabular component of a total hip arthroplasty with cement in young patients without rheumatoid arthritis.

The results for eighty-two young patients without rheumatoid arthritis who had had eighty-seven revisions of the acetabular component because of aseptic loosening were studied. The mean duration of follow-up was approximately six years (range, 1.9 to 18.1 years). The clinical result was excellent or satisfactory for seventy-nine hips (91 per cent). However, at the latest radiographic assessment, twenty-six sockets were loose. Of the fifty hips that had had good bone stock (only slight enlargement of the acetabulum or local defects involving only one wall) before the revision, seven (14 per cent) had loosening of the socket, compared with nineteen (51 per cent) of the thirty-seven that had had poor bone stock (massive or global collapse of the acetabulum and defects involving at least two walls). The relationship between loosening and the quality of the bone stock before the revision was highly significant (p = 0.0002, chi-square test). The results of revision of the socket with use of cement and without use of any bone grafts in young patients who have poor acetabular bone stock are not very encouraging. The need for regular follow-up of all patients who have had an arthroplasty cannot be overemphasized.