Second-generation Porous-coated Cementless Total Hip Arthroplasties Have High Survival

We retrospectively reviewed 157 consecutive total hip arthroplasties performed with Prodigy stems and Duraloc cups to see whether design modifications made to these components would improve their clinical performance as compared with first-generation porous-coated components. At an average of 6.7 years postoperatively, 145 hips were available for followup. The data suggested encouraging clinical and radiographic performances for these second-generation components. With only two hips (1.4%) in this population being revised, survivorship analysis was 99% 5 years postoperatively. Bone ingrowth was evident in 99% of the stems, and all cups were stable at last followup. Large osteolytic lesions were observed in three acetabula and seven femurs with all femoral lesions being confined to the proximal Gruen Zones 1 or 7. Polyethylene wear averaged 0.10 +/- 0.14 mm/year. Ninety-eight percent of patients reported satisfaction with the procedure, and 7% reported activity-limiting pain. Early followup of the Prodigy-Duraloc combination in primary cementless total hip arthroplasties showed the Prodigy stem had similarly good clinical results compared with its predecessor, the AML stem, and the Duraloc cup was superior to its first-generation predecessor, the anatomic medullary locking cup with Acetabular Cup System (ACS) liner.