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IS THE CHARNLEY HIP STILL THE GOLD STANDARD? THE MEDIUM-TERM RESULTS OF THE CHARNLEY IMPLANTED THROUGH A POSTERIOR APPROACH



Abstract

From February 1992 to December 1997, 379 total hip arthroplasties in 342 patients were performed. 13 patients were lost to follow up, with 33 unrelated deaths. All arthroplasties were performed via the posterior approach in the lateral position. All patients were enrolled in an arthroplasty register at the time of surgery by the operating surgeon. Patients underwent clinical and radiological follow up. Kaplan-Meier survivorship analysis was used to determine the failure rate of the prosthesis, with revision surgery or decision to revise as the end-point.

The overall survivorship from all causes of failure at 5–10 years was 99.4%.

There were two stem revisions. One stem was revised for aseptic loosening at 4 years and one revised for recurrent dislocation. The stem aseptic loosening rate was 0.26%.

The cup aseptic loosening rate was 0%. The dislocation rate was 0.53% (2 from 379).

The superficial infection rate was 0.53% (2 from 379). There were no deep infections in this series.

At 12 months 71.2% had no pain (270 from 379), and 53.8% (204 from 379) had normal function. 94.5% said the procedure was worthwhile or very good. At 12 months radiological follow-up revealed progressive radioluceny in 7.65% (29 from 379) acetabuli, and progressive radiolucency in 2.90% (11 from 379) femora (one progressing to revision for aseptic loosening). No acetabular cups required revision.

In patients aged 65 years or younger at the time of surgery the survivorship was 100% for both components. Attention to meticulous and consistent operative technique in acetabular and femoral preparation, in particular a complete cement mantle with good zone 7 cement and osseointegrated cement bone interfaces, enables these results to be achieved.

In 2004 the Charnely Hip replacement remains the Gold Standard hip replacement.

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.