Charnley low-friction arthroplasty in young patients with osteoarthritis: outcomes at a minimum of twenty-two years.
BACKGROUND
We previously reported the outcomes at a minimum of twelve years after eighty-four Charnley low-friction arthroplasties performed in patients with osteoarthritis who were less than fifty-six years old at the time of the surgery. We now update the results of that cohort at a minimum of twenty-two years postoperatively.


METHODS
Eighty-four hips (in sixty-nine patients) with osteoarthritis, which was secondary to congenital hip disease in sixty-four (76%) of them, were followed prospectively with use of the Merle D'Aubigné and Postel scoring system as modified by Charnley and with serial radiographs.


RESULTS
At the time of the latest follow-up, thirty-seven hips (44%) had failed. Twenty-eight acetabular and thirty femoral components, in a total of thirty-two hips, had been revised because of aseptic loosening; six of the loose femoral components were broken. Three hips were infected and were converted to a resection arthroplasty. A periprosthetic femoral fracture occurred in two additional hips, three and ten years postoperatively, and both were treated with internal fixation. Thirty-seven original acetabular components and thirty-six original femoral components were in place for an average of twenty-nine years. The probability of survival for both components, with failure for any reason as the end point, was 0.51 (95% confidence interval, 0.39 to 0.62) at twenty-five years.


CONCLUSIONS
These long-term results can be used as a benchmark with which to compare outcomes of different designs when total hip arthroplasty is performed in young patients when the majority have congenital hip disease.
Georgiades
George
G
Orthopaedic Department, Tripoli Hospital, N Psychiko, Athens, Greece. gegeorgiades@yahoo.com
Babis
George C
GC
Hartofilakidis
George
G
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D055815:Young Adult