Abstract
Introduction: We present our results of the first 413 Charnley arthroplasties performed by and under the supervision of the senior surgeon, using the posterior approach.
Methods: This is a prospective study of clinical and radiographic outcomes. Four hundred and thirteen hip replacements were performed in 380 patients (215 female and 165 male) between 1992 and 1996. The mean age at the time of primary surgery was 67 years (28 – 91 years).
Results: The primary aetiology in 297 of the hips was osteoarthritis. Eighty-two had rheumatoid arthritis.
Eleven patients (3%) had one or more episodes of dislocation.
There were 22 revisions. Three of the revisions were carried out for infection, and a further 2 for recurrent dislocation. Aseptic loosening was the cause of failure in the remaining 17.
Thirty three patients (36 hips, 9%) could not be traced at the time of the final follow-up. There was significant and maintained improvement in pain and function scores.
One hundred and thirty eight patients (146 hips) had died at the time of the final follow-up.
The best and worst case survivorship figures at 10 years were 93 +/− 2% and 83 +/− 2%, and those at 14 years were 88 +/− 4% and 78 +/− 4%, respectively, with revision for any reason as the end-point.
Discussion: Excellent results for the Charnley hip are possible using the posterior approach and surgeons of varying experience. The results presented compare favourably with the published data and confirm that the Charnley remains the gold-standard for longevity in hip arthroplasty. The newer and more costly implants not only need to reproduce these results but also match the cost effectiveness of this prosthesis.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
