Survival of patients and prostheses after total hip arthroplasty

The survival statistics of 695 patients who had 803 total hip arthroplasties (THA) were correlated with the incidence of aseptic loosening using standard actuarial methods. Follow-up periods ranged from three to 11 years. High patient mortality was associated with factors that lower physical fitness: old age, bilateral hip disease, excessive obesity, diagnosis of rheumatoid arthritis, and post-traumatic changes. Patients in whom revision procedures were done due to prosthetic failure experienced a very low mortality. The factors associated with aseptic loosening were unilateral hip disease, defective surgical technique, and excessive body weight (greater than 80 kg). The increased rates of aseptic loosening that have been observed during the later years of follow-up evaluation were attributable to higher survival rates of the more physically fit individuals in the population at risk.