Long-term results of aseptic cemented Charnley revisions

One hundred eighty low-friction arthroplasties of the hip in 164 patients in first-time revision surgery were operated between 1973 and 1985. This series used only cement fixation, and aseptic loosening and femoral stem fractures were the only indications for revision. The average follow-up period was 11.5 years. Intra-operative and postoperative complications were frequent: femoral shaft fracture (13 cases), femoral shaft perforation (12 cases), deep infection (14 cases), and dislocation (15 cases). Twenty-eight hips were rerevised or removed (resulting in a total cumulative probability of rerevision of 20% after 16 years, according to survivorship analysis). Nineteen cups were rerevised (13% after 16 years, according to survivorship analysis), and 24 femoral stems were rerevised (16% after 16 years, according to survivorship analysis). Radiographic cup and femoral loosening appeared in 29 and 36 cases, respectively (24 and 22% after 16 years, respectively, according to survivorship analysis). Good results were observed when there was a healthy and intact bone bed, whereas poor results were related to inadequate bone stock in the acetabulum and femur. Radiolucent lines were frequent in both components; radiolucent lines less than 2 mm wide were frequent in acetabular zone 1. Pistoning of the prosthesis and the cement within the bone and calcar pivot was the most frequent type of stem loosening.