Acetabular Subchondral Bone Decortication and Its Role in the Outcome of Cemented Total Hip Replacement in Young Patients

PURPOSE: Long-term fixation of cemented acetabular components can be problematic in younger active patients. Our technique is put forward to improve outcomes and maximize implant survivorship in this particular patient population. MATERIALS AND METHODS: We report on a cohort of young adult patients (less than 55 years old) with cemented total hip replacement (THR) using a novel technique in preparing and cementing the acetabulum with a minimum follow-up of 10 years (mean follow-up, 14 years). Retrospectively collected data on clinical and radiological outcomes were reviewed. RESULTS: Sixty-five THRs were performed with the minimum study follow-up period. Average age for patients was 44 years old (range, 19–55 years). The mean Hip Disability and Osteoarthritis Outcome Score for patients at final appointment was 92.7. Radiographs taken at an average of 14 years after operation showed 63 of 65 hips showed no evidence of any radiological loosening. Cup survivorship was 100% at the end of the study period. CONCLUSION: Our technique of preparing the acetabulum in combination with cement fixation is reproducible with excellent results in a cohort of patients prone to early aseptic loosening of the acetabular component.