title: The continued value of clinical and radiological surveillance: the Charnley Elite Plus hip replacement system at 12 years.
abstract: We report the follow-up at 12 years of the use of the Elite Plus total hip replacement (THR). We have previously reported the results at a mean of 6.4 years. Of the 217 patients (234 THRs), 83 had died and nine had been lost to follow-up. The patients were reviewed radiologically and clinically using the Oxford hip score. Of the 234 THRs, 19 (8.1%) had required a revision by the final follow-up in all but one for aseptic loosening. Survivorship analysis for revision showed a survival of 93.9% (95% confidence interval (CI) 89.2 to 96.5) at ten years, and of 88.0% (95% CI 81.8 to 92.3) at 12 years. At the final follow-up survival analysis showed that 37% (95% CI 37.3 to 44.7) of the prostheses had either failed radiologically or had been revised. Patients with a radiologically loose femoral component had a significantly poorer Oxford hip score than those with a well-fixed component (p = 0.03). Radiological loosening at 6.4 years was predictive of failure at 12 years. Medium-term radiographs and clinical scores should be included in the surveillance of THR to give an early indication of the performance of specific implants.
authors.affiliation: Institute of Orthopaedics Norfolk, Norwich University Hospital, Norwich, UK. ben@ollivere.co.uk
authors.forename: B
authors.initials: B
authors.lastname: Ollivere
authors.forename: C
authors.initials: C
authors.lastname: Darrah
authors.forename: R C
authors.initials: RC
authors.lastname: Brankin
authors.forename: S T
authors.initials: ST
authors.lastname: Donell
authors.forename: S T
authors.initials: ST
authors.lastname: Donnell
authors.forename: N P
authors.initials: NP
authors.lastname: Walton
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D002484:Cementation / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome