High Risk of Revision Associated with the L-Cup Titanium Alloy Porous Coated Acetabular Component in Primary Total Hip Arthroplasty: Minimum Follow-Up of 14 Years

Abstract

Background: Hip joint pain due to arthritis is a prevalent issue in adults, often necessitating surgical intervention such as total hip arthroplasty (THA). This procedure has been celebrated for its reliability; however, successful outcomes depend on numerous factors. Current advancements are focused on improving implant design and surgical methodologies. This study aimed to evaluate the long-term clinical and functional outcomes of uncemented total hip arthroplasty utilizing the L-Cup acetabular component. Methods: Between February 1999 and November 2010, 351 L-Cup components were implanted in 315 patients. A follow-up period ranged from 14 to 25 years. The clinical outcomes were assessed using the modified Merle d’Aubigné and Postel (MAP) classification and patient satisfaction was measured using a Visual Analog Scale (VAS). Results: Postoperative evaluations showed significant improvement, with VAS scores decreasing from a mean of 7.2 to 2.1, indicating substantial pain alleviation. The modified MAP classification showed a significant improvement of 6.3 points throughout the follow-up period. The results revealed that 49.5% of the cases were classified as excellent, while 20.5% had poor outcomes due to prosthesis loosening. According to the Kaplan–Meier estimator, the 5-year survival rate for the acetabular component was 97.78%, with survival rates of 90.5% at 10 years, 80.45% at 15 years, and 73.79% at 20 years. Conclusions: Total hip arthroplasty is an effective treatment for advanced degenerative joint diseases. While significant postoperative improvements were documented, the observed prosthesis loosening in 20.5% of cases raises concerns about the long-term effectiveness of the L-Cup acetabular component and suggests the need for further refinement in surgical techniques and implant design.