Early Failure of Hybrid Total Hip Arthroplasty with Centralign Femoral Component for Rheumatoid Hips

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Objective: The aim of this study was to examine the postoperative clinical results of total hip arthroplasty (THA) with a grit-blasted roughened-surface polymethyl methacrylate (PMMA) -precoated femoral component.<BR>Methods: A retrospective study was performed on a consecutive series of 25 primary THAs for patients with rheumatoid arthritis (RA) . A roughened-surface PMMA-precoated femoral component (Centralign, Zimmer, Inc) was used with so-called third generation cementing techniques for all cases. In 16 cases, the acetabular component was a Harris-Galante II (Zimmer, Inc) and in 9 cases a Trilogy (Zimmer, Inc) with screw fixation. The average follow-up duration was 54 months (range, 31-91) . Patient's average age was 57 years at primary arthroplasty.<BR>Results: Clinical and radiographic failure occurred in 5 hips (20%) due to aseptic mechanical loosening of the femoral component. All these 5 cases showed implant loosening within 36 months after primary surgery. All stems in the failure group were Size 2. There was a statistical trend towards failure with smaller stem sizes (p<0.01) . No loosening was seen in the acetabular component.<BR>Conclusion: This high failure rate was unacceptable in an RA series, in spite of the subjects' limited activity. Use of Centralign femoral components may not be indicated for rheumatoid hips.
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