Surface replacement arthroplasty of the hip. Experience with the ICLH method

Fifty-six ICLH-surface replacement arthroplasties of the hip were followed up prospectively for 1 to 6 years postoperatively, mean 2.5 years. Fifty-one hips had osteoarthritis and five rheumatoid arthritis. Pain, motion, walking ability, and function were considerably improved after surgery. It is our impression that the clinical results were equal to those obtained by conventional stemmed hip arthroplasties. Complications were recorded in nine hips, with femoral neck fracture in two, loosening of both components in two, and loosening of the acetabular component in five. Three of the failures occurred in the five hips with rheumatoid arthritis. The high failure rate is disturbing, and we now limit the indications for this procedure to patients with osteoarthritis, 40-60 years of age, and with good bone stock.