Early failure of a roughened surface, precoated femoral component in total hip arthroplasty

A retrospective study was performed of a consecutive series examining 98 primary hip arthroplasties between March 1992 and December 1995. A second-generation roughened surface (grit-blasted), polymethyl methacrylare-precoated femoral component (Centralign prosthesis, Zimmer. Inc, Warsaw, IN) was used for all cases. Clinical and radiographic data were available for 84 hips (76 patients). The average duration of follow-up was 35.8 months. There were 10 failures by aseptic mechanical loosening of the femoral component (12%) at an average 30.6 months postoperatively, 9 having been revised (11%). Revision was pending in the remaining patient. The average age of patients at primary arthroplasty for the failed group was 48.2 years compared with 63.4 years for the asymptomatic patients (P = .0008). In all cases, failures occurred by debonding of the femoral prosthesis from the cement mantle. We are not aware of any series using modern implant components and cementing techniques with an early mechanical failure rate of this magnitude.