The operation of the century almost half-century later. Report of eleven total hip replacements survived 40 years and more
Keywords:
long-term survival, survival of total hip arthroplasty, survival of total hip replacement, low friction arthroplasty, survival over 40 yearsAbstract
Background Total hip replacement (THR) is one of the most successful orthopaedic procedures. However, the main concern of the longevity of the prosthesis during lifelong still exists. The purpose of the present study was to report, as far as we know, for the first time in the literature the longest-term results of THR.
Methods From 164 consecutive THRs that were performed by one surgeon (GH) between 1974 and 1980 with the first-generation technique and implants introduced by John Charnley, 11 in nine patients survived 40 years and more. The surgeon who performed the operations followed these patients consistently since then.
Results At the final follow-up of the 11 hips that survived without revision for 40 years and more (mean, 42; range, 40-46), the mean patients’ age was 85 years (range, 67-98). Clinically, all patients had significantly improved Merle d’Aubigné and Postel score, as modified by Charnley, in comparison with the respective pre-operative ones (p < 0.001).
Conclusion To our knowledge this is the first report in the literature presenting survival of a method of THR for almost half of a century. The presentation of 11 THRs survived without revision for 40 to 46 years in combination with the previously mentioned in the literature successful outcomes of the first modern THR, the Charnley’s low friction arthoplasty, overpassing 30 years indicates that THR can be last lifelong for a middle-aged patient.
Downloads
References
2. Charnley J. Arthroplasty of the hip. A new operation. Lancet 1961; 1(7187):1129-32.
3. Karlson EW, Mandl LA, Aweh GN, et al. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med 2003; 114(2):93-8.
4. Bitton R. The economic burden of osteoarthritis. Am J Manag Care 2009; 15(8 Suppl):S230-5.
5. Global Market Study on Hip Replacement: Availability of New and Advanced Hip Implants Boosting Revenue Growth. Available by https://www.prnewswire.com/news-releases/global-market-study-on-hip-replacement-availability-of-new-and-advanced-hip-implants-boosting-revenue-growth-300637645.html. Published Apr 2018. Accessed March 2020.
6. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet 2007; 370(9597):1508-19.
7. Charnley J. Low friction arthroplasty of the hip: theory and practice. Charnley J, (ed). Berlin: Springer-Verlag 1979.
8. Hartofilakidis G, Stamos K, Karachalios T, et al. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 1996; 78(5):683-92.
9. Karachalios T, Roidis N, Lampropoulou-Adamidou K, et al. Acetabular reconstruction in patients with low and high dislocation: 20- to 32-year survival of an impaction grafting technique (named cotyloplasty). Bone Joint J 2013; 95-B(7):887-92.
10. Harris WH, McCarthy JCJ, O’Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 1982; 64(7):1063-7.
11. Charnley J. The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg Br 1972; 54(1):61-76.
12. Warth LC, Callaghan JJ, Liu SS, et al. Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old. A concise follow-up of previous reports. J Bone Joint Surg Am 2014; 96(21):1814-9.
13. Glyn-Jones S, Thomas GE, Garfjeld-Roberts P, et al. The John Charnley Award: Highly crosslinked polyethylene in total hip arthroplasty decreases long-term wear: a double-blind randomized trial. Clin Orthop Relat Res 2015; 473(2):432-8.
14. Mulroy RD, Jr., Harris WH. The effect of improved cementing techniques on component loosening in total hip replacement. An 11-year radiographic review. J Bone Joint Surg Br 1990; 72(5):757-60.
15. Hartofilakidis GC, Lampropoulou-Adamidou KI, Stathopoulos IP, et al. The Outcome of 241 Charnley Total Hip Arthroplasties Performed by One Surgeon 30 to 40 Years Ago. J Arthroplasty 2015; 30(10):1767-71.
16. Wroblewski BM, Siney PD, Fleming PA. Charnley low-frictional torque arthroplasty: follow-up for 30 to 40 years. J Bone Joint Surg Br 2009; 91(4):447-50.
17. Callaghan JJ, Bracha P, Liu SS, et al. Survivorship of a Charnley total hip arthroplasty. A concise follow-up, at a minimum of thirty-five years, of previous reports. J Bone Joint Surg Am 2009; 91(11):2617-21.
18. Charnley J. Fracture of femoral prostheses in total hip replacement. A clinical study. Clin Orthop Relat Res 1975; (111):105-20.
19. Wroblewski BM. Direction and rate of socket wear in Charnley low-friction arthroplasty. J Bone Joint Surg Br 1985; 67(5):757-61.
20. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am 1982; 64(9):1295-306.
21. Russell RD, Estrera KA, Pivec R, et al. What’s new in total hip arthroplasty. J Bone Joint Surg Am 2013; 95(18):1719-25.
22. Lee JM. The Current Concepts of Total Hip Arthroplasty. Hip Pelvis 2016; 28(4):191-200.
23. Jones LC, Hungerford DS. Cement disease. Clin Orthop Relat Res 1987; (225):192-206.
24. Harris WH, Schiller AL, Scholler JM, et al. Extensive localized bone resorption in the femur following total hip replacement. J Bone Joint Surg Am 1976; 58(5):612-8.
25. Maloney WJ, Jasty M, Harris WH, et al. Endosteal erosion in association with stable uncemented femoral components. J Bone Joint Surg Am 1990; 72(7):1025-34.
26. Amstutz HC, Campbell P, Kossovsky N, et al. Mechanism and clinical significance of wear debris-induced osteolysis. Clin Orthop Relat Res 1992; (276):7-18.
27. Levy YD, Ezzet KA. Poor short term outcome with a metal-on-metal total hip arthroplasty. J Arthroplasty 2013; 28(7):1212-7.
28. Benelli G, Maritato M, Cerulli Mariani P, et al. Revision of ASR hip arthroplasty: analysis of two hundred and ninety six recalled patients at seven years. Int Orthop 2019; 43(1):97-101.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Acta Orthopaedica Et Traumatologica Hellenica
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
