Poor survival of cementless Biomet® total hip: A report on 1,047 hips from the Finnish Arthroplasty Register

• Published in: Acta orthopaedica 1999-10, Vol.70 (5), p.425-429
• Main Authors: Puolakka, Timo J S, Pajamäki, K J Jorma, Pulkkinen, Pekka O, Nevalainen, Juha K
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; Biological and medical sciences; Bone Cements; Equipment Failure Analysis; Female; Finland; Hip Prosthesis - adverse effects; Hip Prosthesis - statistics & numerical data; Hip Prosthesis - trends; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteoarthritis, Hip - diagnostic imaging; Osteoarthritis, Hip - surgery; Proportional Hazards Models; Prosthesis Design; Prosthesis Failure; Radiography; Registries; Reoperation - statistics & numerical data; Sex Distribution; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Treatment Outcome
• ISSN: 1745-3674; 0001-6470; 1745-3682
• DOI: 10.3109/17453679909000975

In Finland, almost 50% of all hip replacements done after 1989 have been inserted without cement. Biomet® components have been the most commonly used implants in cementless arthroplasties. Between 1985 and 1997, 4,300 prostheses were implanted because of primary osteoarthrosis. 4 different acetabular component designs have been identified as Biomet implants (Mallory-Head, Romanus, T-TAP, Universal) and were used in 1,047 hips. The 9-year survival of all arthroplasties using Biomet cups was only 65 (95% CI 61-69)%. while that of arthroplasties using T-TAP-cups was only 58 (52-65)%. In contrast, the 7.5-year survival of arthroplasties using Romanus cups was 85 (79-91)%. The 98 (96-99)% 5-year survival of arthroplasties with Mallory-Head cups should be interpreted cautiously, since similar results of arthroplasties using the Universal cup with the same type of liner decline sharply to 93 (88-98)% only 1 year later. The poor survival of Biomet cementless prostheses in our series seems to be related to the poor survival of the cup. This finding was common to all metal shell designs using Hexloc liners. We recommend that Biomet cups with Hexloc liners should not be used and patients who have had them inserted should undergo regular clinical and radiographic follow-ups.