The operation of the century almost half-century later. Report of eleven total hip replacements survived 40 years and more

  • George Hartofilakidis
  • Kalliopi Lampropoulou-Adamidou
Keywords: long-term survival, survival of total hip arthroplasty, survival of total hip replacement, low friction arthroplasty, survival over 40 years


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.


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Author Biographies

George Hartofilakidis

Laboratory for the Research of Musculoskeletal Disorders “Th. Garofalides”, Medical School,
National and Kapodistrian University of Athens, Greece

Kalliopi Lampropoulou-Adamidou

Laboratory for the Research of Musculoskeletal Disorders “Th. Garofalides”, Medical School,
National and Kapodistrian University of Athens, Greece


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