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Long-term survival of McKee-Farrar total hip prostheses
Stephen R Brown1, William A Davies, David H DeHeer
1Grand Rapids Orthopaedic Surgery Residency Program, MI, USA.
Abstract:
Because of the recent resurgence of interest in metal-on-metal bearing components for total hip arthroplasties, the long-term results of 153 consecutive McKee-Farrar total hip arthroplasties done in 129 patients by one surgeon between 1969 and 1973 were evaluated. A retrospective chart review provided patient demographics (age, gender, weight, primary diagnosis), revision dates, indications, and implant survival data. The average age of the patients at implantation surgery was 61 years (range, 28-85 years) and these patients were observed as many as 28 years. Primary diagnoses included osteoarthritis (49% of implants), rheumatoid arthritis (38%), and other conditions (13%). During the 28 years of followup, five implants were revised for infection and 14 implants were revised for aseptic loosening. Survivorship analysis of the McKee-Farrar prostheses had a 20-year probability of implant survivorship of 84%, and a 28-year implant survivorship of 74%. Excellent long-term results of the McKee-Farrar prosthesis were seen. Given the inherent problems associated with implant wear debris, especially polyethylene wear particles, second generation metal-on-metal bearing implants may offer a viable alternative to current designs. Their excellent long-term survival may infer particular suitability for use in younger patients.
Insights
The McKee-Farrar metal-on-metal hip prosthesis showed excellent long-term survival, with a 74% survival rate at 28 years. This suggests metal-on-metal implants may be a viable alternative for younger patients.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Implantology
Background:
- Resurgence of interest in metal-on-metal (MOM) bearing components for total hip arthroplasties (THAs).
- Need for long-term data on older MOM designs like the McKee-Farrar prosthesis.
- Concerns regarding polyethylene wear debris in current THA designs.
Purpose of the Study:
- Evaluate the long-term results and implant survivorship of the McKee-Farrar total hip arthroplasty.
- Assess the suitability of MOM implants for younger patient populations.
- Provide data to inform the design and application of next-generation MOM implants.
Main Methods:
- Retrospective chart review of 153 consecutive McKee-Farrar THAs performed between 1969 and 1973.
- Analysis of patient demographics, diagnoses, revision dates, and indications.
- Survivorship analysis using Kaplan-Meier methods.
Main Results:
- Average patient age at implantation was 61 years, with follow-up up to 28 years.
- 20-year implant survivorship probability was 84%; 28-year survivorship was 74%.
- Revision rates were low for infection (5 implants) and aseptic loosening (14 implants).
Conclusions:
- The McKee-Farrar prosthesis demonstrated excellent long-term clinical results and survivorship.
- MOM implants may offer a viable alternative to current THA designs, particularly for younger patients.
- Long-term survival data supports the potential of MOM bearings to address concerns about polyethylene wear.