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Fifteen years' experience with Charnley low-friction arthroplasty
G Hartofilakidis1, K Stamos, T T Ioannidis
1Department of Orthopaedics, University of Athens, Greece.
Insights
The Charnley low-friction arthroplasty shows excellent long-term results, with over 90% of patients remaining asymptomatic after five years. This hip replacement technique demonstrates encouraging outcomes for hip arthroplasty continuation.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Hip arthroplasty is a common procedure for hip joint dysfunction.
- The Charnley low-friction arthroplasty technique has been utilized since 1973.
- Long-term clinical and radiological outcomes are crucial for evaluating arthroplasty success.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of low-friction hip arthroplasty performed using the Charnley technique.
- To assess the relationship between follow-up duration, patient age, and implant performance.
Main Methods:
- A retrospective study of 310 patients (359 hips) who underwent Charnley low-friction arthroplasty between 1973 and 1986.
- Clinical evaluation based on follow-up time (Groups A, B, C).
- Roentgenological assessment of asymptomatic hips, including radiolucent lines, cortical hypertrophy, and cup wear.
Main Results:
- Asymptomatic rates were 78.49% (10-14 years), 92.02% (5-9 years), and 98.38% (1-4 years).
- Infection rates were 9.6% (10-14 years) and 4.7% (5-9 years).
- Radiolucent acetabular lines (40.6%), stem hypertrophy (48.8%), and cup wear >1mm (41.3%) were observed, correlated with longer follow-up and younger age.
Conclusions:
- The Charnley low-friction arthroplasty demonstrates favorable long-term clinical outcomes.
- Radiological findings indicate wear and loosening potential, particularly with extended follow-up.
- The technique remains a viable option for hip arthroplasty, warranting continued use and monitoring.
Abstract:
In the years from 1973 to 1986, 359 low-friction hip arthroplasties were performed by the precise Charnley technique in 310 patients. Three hundred seventeen hips were reexamined both clinically and roentgenologically. Clinical evaluation was performed according to follow-up time, separating the total number of hips into three groups. In Group A, 78.49% of the reevaluated hips remained asymptomatic ten to 14 years postoperatively, a percentage that has risen to 92.02% in Group B (studied five to nine years postoperatively) and 98.38% in Group C (studied one to four years postoperatively). The infection rate was 9.6% in Group A hips, 4.7% in Group B hips, and inconsequential in Group C hips. The roentgenographic study included 96 asymptomatic hips with a follow-up period of six to 11 years (mean, 8.3%). A radiolucent line was present in the acetabulum in 40.6% of cases; cortical hypertrophy at the tip of the stem was present in 48.8% of cases. Cup wear of more than 1 mm was measured in 41.3% of hips and was correlated with longer follow-up times and younger patient age. The results are encouraging for the continuation of arthroplasty by this method.