Excellent Short-term Results of Articular Surface Replacement XL Total Hip Arthroplasty

Symptoms of pain, loosening and squeaking were historically reported as the main revision reasons for articular surface replacement XL (ASR XL) total hip arthroplasty. A total of 42 cementless primary total hip arthroplasties using ultra large-diameter femoral head and mono block acetabular component were performed in our institution. These consecutive 42 arthroplasties were retrospectively reviewed and the results were recorded and analysed. After an average 3-year follow-up period (range, 2.5-3.6 years), 42 primary replacements in 39 patients could be reviewed fully. Mean age at surgery was 51.9 years (range, 20-92 years). Pain was noted in 4 hips and squeaking was noted in 1 hip. According to Harris rating system, clinical results were graded excellent and good in 93% of hips and fair in 7%. Radio-logically, the cup abduction angle of the acetabular components for all symptomatic hips was in acceptable realm. There has been no osteolysis or asceptic loosening on both sides of the hip. The failure rate of ASR XL total hip arthroplasty was 2% at early follow-up. The controversial ASR XL acetabular component could yield excellent clinical results in some circumstances.