Related Experiment Video
Updated: Jul 16, 2026
Biotribological Testing and Analysis of Articular Cartilage Sliding against Metal for Implants
Published on: May 14, 2020
Charnley low-friction arthroplasty for Paget's disease of the hip
1The Manchester Arthroplasty Unit, North Manchester General Hospital, Crumpsall, United Kingdom.
Insights
Total hip arthroplasty for Paget's disease shows good long-term implant survival. The primary complication observed was trochanteric osteotomy nonunion, with low rates of aseptic loosening.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomaterials Science
Background:
- Paget's disease of bone can lead to severe hip joint degeneration, necessitating surgical intervention.
- Total hip arthroplasty (THA) is a common treatment for end-stage hip disease in Pagetic patients.
- Understanding the specific risks and outcomes of THA in this population is crucial for patient management.
Purpose of the Study:
- To evaluate the risks and complications associated with Charnley low-friction arthroplasty in patients with Paget's disease.
- To assess the long-term survivorship and functional outcomes of THA in this cohort.
- To identify any unique challenges or increased risks in performing THA for Paget's disease.
Main Methods:
- Retrospective analysis of 98 Charnley low-friction arthroplasties in 76 patients with Paget's disease.
- Data collection included intraoperative blood loss, heterotopic ossification, implant loosening, and revision rates.
- Long-term follow-up averaged 10.4 years, with survivorship analysis performed for acetabular and femoral components.
Main Results:
- Minor heterotopic ossification occurred in 25% of hips, with significant changes in 4%.
- Aseptic loosening was observed in 10% of acetabular and 8% of femoral components.
- Survivorship to revision was high: 98% at 10 years for acetabular and 93% for femoral components.
- The main identified risk was nonunion of the trochanteric osteotomy (13%).
Conclusions:
- Charnley low-friction arthroplasty demonstrates favorable long-term survivorship in patients with Paget's disease.
- While aseptic loosening and heterotopic ossification are potential complications, they appear manageable.
- Nonunion of the trochanteric osteotomy is a notable complication specific to this patient group.
Abstract:
This study investigated the perceived risks and complications associated with total hip arthroplasty for Paget's disease. A total of 98 Charnley low-friction arthroplasties were performed on 76 patients, 27 men (37 hips) and 49 women (61 hips), whose average age was 67.4 years (range, 51-79 years). Intraoperative blood loss averaged 388 mL (range, 110-1,730 mL), and minor heterotopic ossification occurred in 24 hips (25%), with significant changes in 4 hips (4%). After average follow-up of 10.4 years (range, 5.5-20 years), 10 acetabular (10%) and 8 femoral (8%) implants had loosened aseptically, but there was no evidence of progressive protrusio acetabuli or femoral deformity after operation. Survivorship to revision was 98% at 10 years (95% confidence interval [CI], 95%-100%) and 91% at 15 years (95% CI, 80%-100%) for the acetabular component and 93% (95% CI, 87%-99%) and 89% (95% CI, 80%-99%) for the femur. The only increased risk identified was nonunion of the trochanteric osteotomy (13%).
