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The Outcome of 241 Charnley Total Hip Arthroplasties Performed by One Surgeon 30 to 40 Years Ago
George C Hartofilakidis1, Kalliopi I Lampropoulou-Adamidou2, Ioannis P Stathopoulos2
1Laboratory for the Research of Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, General Hospital of Athens KAT, Athens, Greece.
Insights
This study evaluated low friction arthroplasties (LFAs) over 30-40 years. Results show a 53% survival rate at 30 years, with younger patients facing higher failure risks.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Low friction arthroplasty (LFA) has been a significant advancement in hip replacement surgery.
- Long-term outcomes of early LFA procedures are crucial for understanding implant longevity and patient factors.
Purpose of the Study:
- To assess the long-term survival and failure modes of Charnley low friction arthroplasties (LFAs) performed 30-40 years ago.
- To identify risk factors associated with LFA failure, including patient age, gender, and diagnosis.
Main Methods:
- Retrospective analysis of 241 consecutive low friction arthroplasties (LFAs) performed by a single surgeon.
- Survival analysis using revision or component removal as the endpoint.
- Cox regression analysis to evaluate risk factors for implant failure.
Main Results:
- The overall survival rate at 30 years was 53% (95% CI 43.2-62.8%) among the 40 hips remaining in the study.
- Younger patients demonstrated a significantly higher risk of overall LFA failure.
- Younger patients and those with congenital hip disease showed an increased risk of failure due to loosening.
Conclusions:
- Charnley LFAs performed three to four decades ago exhibit moderate long-term survival rates.
- Patient age and diagnosis are critical factors influencing the risk of LFA failure, particularly aseptic loosening.
- This study provides a valuable benchmark for comparing the performance of contemporary total hip arthroplasty techniques.
Abstract:
We present the outcome of 241 consecutive low friction arthroplasties (LFAs) performed by one surgeon (GH) 30 to 40 years ago. The overall survival rate at 30 years with revision for any reason or removal of the components as the end point was 53% (43.2-62.8%) when 40 hips remained in the study. Cox regression analysis for the possible risk factors of age, gender and diagnosis revealed higher risk of the overall failure in younger patients, and higher risk of failure due to loosening in younger patients and in those with congenital hip disease. Our follow-up study at 30 to 40 years following Charnley LFA can be used as a benchmark for comparison with the newer methods of total hip arthroplasty.
