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We conducted a longitudinal study including patients with the same type of primary hybrid total hip replacement and evaluated patient activity and femoral osteolysis at either five or ten years post-operatively. Activity was measured using the University of California, Los Angeles scale. The primary outcome was the radiological assessment of femoral osteolysis. Secondary outcomes were revision of the femoral component for aseptic loosening and the patients' quality of life. Of 503 hip replacements in 433 patients with a mean age of 67.7 years (30 to 91), 241 (48%) were seen at five and 262 (52%) at ten years post-operatively. Osteolytic lesions were identified in nine of 166 total hip replacements (5.4%) in patients with low activity, 21 of 279 (7.5%) with moderate activity, and 14 of 58 (24.1%) patients with high activity. The risk of osteolysis increased with participation in a greater number of sporting activities. In multivariate logistic regression adjusting for age, gender, body mass index and the inclination angle of the acetabular component, the adjusted odds ratio for osteolysis comparing high vs moderate activity was 3.6 (95% confidence interval 1.6 to 8.3). Stratification for the cementing technique revealed that lower quality cementing increased the effect of high activity on osteolysis. Revision for aseptic loosening was most frequent with high activity. Patients with the highest activity had the best outcome and highest satisfaction. In conclusion, of patients engaged in high activity, 24% had developed femoral osteolysis five to ten years post-operatively.

Original publication

DOI

10.1302/0301-620x.93b4.25868

Type

Journal article

Journal

The Journal of bone and joint surgery. British volume

Publication Date

04/2011

Volume

93

Pages

456 - 463

Addresses

Division of Orthopaedic Surgery, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, CH-1211 Geneva, Switzerland.

Keywords

Femur, Acetabulum, Humans, Osteolysis, Prosthesis Failure, Bone Cements, Range of Motion, Articular, Treatment Outcome, Exercise, Activities of Daily Living, Arthroplasty, Replacement, Hip, Regression Analysis, Follow-Up Studies, Hip Prosthesis, Time Factors, Sports, Aged, Aged, 80 and over, Middle Aged, Female, Male