High long-term loosening rate of conical screw cups

BACKGROUND: Acetabular screw cups seem to give high primary stability. We analyzed the migration and loosening behavior of a first-generation screw cup in a longterm follow-up. PATIENTS AND METHODS: We examined 92 uncemented titanium alloy conical screw cups prospectively. Implant migration was assessed with a digital high-precision method (EBRA) with an accuracy of 1.0 mm. RESULTS: After mean 11 (0.5-18) years, 87 patients were available for examination and 5 patients had died. 32 implants had been revised and 7 cases showed radiographic evidence of loosening. The 10-year survival rate was 71%. Migration of more than 1 mm occurred in 53 hips. Implant survival was strongly associated with an annual migration of greater than 0.2 mm. INTERPRETATION: The long-term behavior of this cup is not satisfactory. In spite of extraordinarily high primary implant stability, secondary osseointegration of this cup often fails. The annual migration rate represents a valid parameter for prediction of implant survival.