title: Charnley low-friction arthroplasty: survival patterns to 38 years.
abstract: We studied survival to 38 years after Charnley low-friction arthroplasty of the hip. We used revision as an end-point, while adopting a policy of regular follow-up and early revision for radiological changes alone if indicated. Between November 1962 and June 2005, 22,066 primary low-friction arthroplasties (17,409 patients) had been performed at Wrightington Hospital by more than 330 surgeons. By June 2006, 1001 (4.5%) hips had been revised and 1490 patients (2662 hips, 12%) had died. At 31 years, where a minimum of 40 hips were still attending follow-up, survival with revision for infection as an endpoint was 95%, for dislocation 98%, for a fractured stem 88.6%, for a loose stem 72.5% and for a loose acetabular component 53.7%. Wear and loosening of the ultra-high-molecular-weight polyethylene acetabular component were the main long-term problems. We conclude that regular follow-up after hip replacement is essential and that all operative findings should be recorded at revision.
authors.affiliation: The John Charnley Research Institute Wrightington Hospital, Appley Bridge, near Wigan, UK.
authors.forename: B M
authors.initials: BM
authors.lastname: Wroblewski
authors.forename: P D
authors.initials: PD
authors.lastname: Siney
authors.forename: P A
authors.initials: PA
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome