High revision rate of hydroxyapatite-coated ABG-I prosthesis

The aim of this study was to investigate the causes of the high revision rate of the hydroxyapatite-coated Anatomique Benoist Girard (ABG-I) prosthesis. We performed 204 total hip arthroplasties (THAs) at our hospital between March 1992 and December 1996. Of the 204 THA patients, 129 were followed up; the mean duration of follow-up was 12.2 years (range 10.0-14.5 years). There were 113 male patients and 16 female patients, with an average age of 53 years (30-83 years) at the time of surgery. The reasons for THA were avascular necrosis in 119 hips, acetabular dysplasia in 8 hips, and traumatic arthritis in 2 hips. The Harris hip score was 47.3 preoperatively and 86.4 at the last follow-up. The linear polyethylene wear was an average of 0.29 mm/year. Acetabular osteolysis was seen in 113 cases (88%). Altogether, 61 (47.2%) acetabular cups were revised for aseptic loosening in 38 hips, polyethylene wear and osteolysis in 20 hips, recurrent dislocation in 2 hips, and deep infection in 1 hip. Femoral osteolysis was observed in 100 cases (77.5%). The femoral stem was revised in 4 hips (3.1%). We observed that the fatal detriment to ABG-I acetabular cup survival in long-term follow-up was periace-tabular osteolysis followed by aseptic loosening.