Poor outcome of the PCA and Harris-Galante hip prostheses: Randomized study of 171 arthroplasties with 9-year follow-up

155 patients (171 hips) with a mean age of 50 years (24-64) were randomized to uncemented PCA (84 hips) or Harris-Galante type I (87 hips) total hip arthroplasty. Clinical and radiographic evaluations were done regularly. The improvements in the Harris hip and pain scores did not differ. Osteolysis developed in 5 PCA and 17 Harris-Galante hips. 13 hips in the PCA and 16 in the Harris-Galante (HG) group were revised because of mechanical failures and 1 hip (HG) because of infection after a mean follow-up of 9 years. Decreased 10-year survival rate, based on revision as end-point, was noted for the PCA (85%), compared with the Harris-Galante cup (99%). The corresponding survival rate of the PCA stem (96%) was higher than that observed for the Harris-Galante design (86%). When radiographic failures were included, the survival rates of the 4 different components dropped to between 73% and 94%. These findings indicate that further revisions will be necessary and continuous radiographic follow-up is indicated to enable revision before severe bone destruction has occurred. Although the PCA and the Harris-Galante designs differed as regards the survival of the individual components, the overall clinical and radiographic survival rates of these cement-less total hip arthroplasties were poor.