Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems: A comparison of 6-year and 10-year follow-up results in 95 patients

Abstract

Background The progress of radiolucent lines (RLs) around the stems of cementless hip endoprostheses and their implications for implant survival are unclear.

Patients and methods 150 consecutive total hip replacements (THRs) were performed between January and July 1993. The presence and development of RLs and osteolyses were monitored with a standardized special radiographic technique, and the results were compared at 6 and 10 years of follow-up in 95 patients.

Results At 6 years, RLs were detectable in 43 of 95 patients. RLs with an extension of 50% of the respective zone were present in 35 patients, almost all in Gruen zones 1 and 7. 2 patients presented with osteolysis. At 10 years, the RLs were almost identical—both in number and thickness. Only 1 additional osteolytic lesion had developed; no cup osteolyses were detected, and there was no significant polyethylene wear.

Interpretation The RLs detected at 6 years were virtually unchanged at 10 years. As they did not progress, they would not jeopardize implant stability. However, the osteolyses seen in 3 patients emphasize the importance of follow-up examinations.

Contributions of authors

KZ: performed many of the operations and wrote the paper. MS: also involved in operations, analyzed the radiographs and reviewed the patients’ charts. US: analyzed radiographs and reviewed the patients’ charts.