Outcome of the Cementless Zweymüller BICON-PLUS Cup and SL-PLUS Stem in the Very Elderly Individuals

INTRODUCTION: There is current debate about which type of total hip prosthesis implants are best for the elderly patient. Implanting uncemented total hip arthroplasty (THA) in elderly people remains contested. The aim of present study was to evaluate the outcome of the uncemented Zweymüller BICON-PLUS THA in those with a minimum of 80 years of age. MATERIALS AND METHODS: A retrospective data collection was performed in a regional teaching hospital in the Netherlands. The primary outcome of interest was the operation-free period. Secondary outcomes included the revision rates of the femoral and acetabular components and postoperative complications of the procedure. After a follow-up of at least 7 years, the surviving patients were reviewed on functionality using validated scores (Hip Disability and Osteoarthritis Outcome Score, Timed Up and Go, and Harris Hip Score) and radiographic analysis. RESULTS: Between January 1999 and September 2004, 124 patients (128 THAs), aged 80 years and older, received an uncemented THA with a BICON-PLUS cup and SL-PLUS stem. The overall operation-free period was 6.5 years. One case of loosening of the cup was found among participants, with a survival rate of 99.2% of the BICON-PLUS cup in the analyzed group. In all, 28.8% of this group could be followed for a postoperative period of at least 7 years. The remainder of the patients died prior to the end of the 7-year period. Of these, 16.0% were eligible for clinical review. This group showed good function without evident signs of prosthetic loosening. CONCLUSION: The uncemented Zweymüller THA system, with threaded BICON-PLUS cup and SL-PLUS stem, showed good results, compared to outcome of other THA systems in elderly individuals. Therefore, it is a reliable option in older patients requiring THA.