Background: Hydroxyapatite coated (HAC) hip implants have been used in clinical practice for more than twodecades. However, the majority of studies have reported only intermediate term outcomes that are not reliable forpredicting long-term behavior in all implants. The aim of this study was to determine the performance of HAC totalhip arthroplasty in younger patients over a 10-year follow-up period.Methods and Results: This was an observational retrospective study of a 137 consecutive hips with the ABG I prosthesis.Of these, 128 were available for the last investigation. Median duration of follow-up was 10.9 years. The meanage at time of index surgery was 46±6.7 years. Probability of implant survival was estimated using the Kaplan-Meiermethod. The overall 12-year cumulative survival was 0.55 (95% CI, 0.443-0.659). Periprosthetic osteolysis (57 %) wasthe most frequent reason for failure followed by aseptic loosening (28 %). When only aseptic loosening was includedin the analysis, the same fi gures for cup and stem were 0.873 (95% CI, 0.808-0.938) and 0.992 (95% CI, 0.976- 1.0),respectively. Patients with a smaller cup size were those at high risk for revision due to wear-related complications(odds ratio, OR=4.3; 95% CI, 1.734-10.555).Conclusion: This study reports one of the poorest 12-year survivorship data for cementless acetabular componentin the literature. The main reason for premature failure was osteolysis, strongly related to high wear rate of polyethylene.

Department of Orthopedics Teaching Hospital and Faculty of Medicine and Dentistry Palacky University Olomouc

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