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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Charnley total hip arthroplasty with cement. Fifteen-year results
B F Kavanagh1, M A Dewitz, D M Ilstrup
1Mayo Clinic, Rochester, Minnesota 55905.
Insights
Long-term follow-up of Charnley total hip arthroplasties shows good pain relief for most patients. While loosening incidence increases over time, failure rates remain relatively low, indicating durable outcomes for cemented hip replacements.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Cemented total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
- Long-term data on the durability and functional outcomes of early cemented THA are crucial for understanding implant longevity.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of the first 333 Charnley total hip arthroplasties performed with cement at the Mayo Clinic.
- To assess the incidence of component loosening and overall failure rates up to fifteen years postoperatively.
Main Methods:
- Retrospective review of 333 cemented Charnley THAs with a minimum fifteen-year follow-up.
- Kaplan-Meier analysis was used to estimate the probability of loosening and failure.
- Mayo Clinic clinical and radiographic scoring system was applied to assess hip function and results.
Main Results:
- Eighty percent of living patients reported no pain at fifteen years.
- 152 of 160 hips showed significant improvement compared to pre-operative status.
- Probable loosening incidence reached 32% at fifteen years, while failure probability was 12.7%.
Conclusions:
- Cemented Charnley total hip arthroplasty provides durable pain relief and functional improvement for most patients over fifteen years.
- While radiographic loosening increases over time, the rate of symptomatic loosening and revision surgery remains acceptable.
- The functional outcomes showed slight deterioration over the long term, highlighting the need for continued monitoring.
Abstract:
The results of the first 333 Charnley total hip arthroplasties that were performed with cement at the Mayo Clinic were reviewed a minimum of fifteen years postoperatively. Data were available for 166 of 170 hips of patients who were still alive. One hundred and thirty patients died, and thirty-seven hips were revised. At the time of this study, 80 per cent of the living patients had no pain, and 152 of the 160 hips remained much better than before the operation. Kaplan-Meier analysis of probable loosening of one or both components, on the basis of roentgenographic evidence, demonstrated a probability of loosening of 3 per cent incidence at one year after operation, 13 per cent at five years, 19 per cent at ten years, and 32 per cent at fifteen years. The probability of failure (that is, revision or symptomatic loosening) was 0.9 per cent at one year, 4.1 per cent at five years, 8.9 per cent at ten years, and 12.7 per cent at fifteen years. We did not identify a dramatic increase in the incidence of loosening or failure at any of the follow-up periods (one, five, ten, or fifteen years). With the Mayo Clinic clinical and roentgenographic system for scoring the hips, we found that ninety-seven hips had a good or excellent result; fifteen, a fair result; and thirteen, a poor result. (The scoring could not be completed for forty-one hips). The functional results deteriorated slightly over time.(ABSTRACT TRUNCATED AT 250 WORDS)
