title: The Elite-Plus stem migrates more than the flanged Charnley stem.
abstract: OBJECTIVE
  The Charnley Elite-Plus stem was introduced in 1993 as a presumed improvement of the flanged Charnley stem. We started this study in 1996 to investigate the migratory pattern of the Elite-Plus stem.
  
  
  METHODS
  We followed 114 patients with osteoarthritis and a primary total hip replacement with the Elite-Plus stem. Mean age at the time of operation was 64 (50-76) years. The mean follow-up time was 6.5 (2-7) years. Radiographs were evaluated with respect to cementing technique, migration, and wear measured by radiostereometry (RSA).
  
  
  RESULTS
  The stem survival was 98% (CI: 96-100) at 7 years and 92% (CI: 86-97) at 10 years. Mean migration of the femoral head was 0.35 mm (SD 0.3) medially, 0.51 mm (SD 0.6) distally, and 1.1 mm (SD 1.8) in the dorsal direction. Mean total point motion was 1.7 mm (SD 1.7). The migration of the stems stabilized after 5 years in the medial and dorsal directions, but continued to subside slightly. Migration along any of the axes was higher if the cementing technique was inferior.
  
  
  CONCLUSIONS
  Patients with a Charnley Elite-Plus stem and defects in the cement mantle or other signs of inferior implantation technique should be carefully monitored.
authors.affiliation: Department of Orthopedics, Lund University, Malmö University Hospital, Malmö, Sweden.
authors.forename: Thord
authors.initials: T
authors.lastname: von Schewelov
authors.forename: Lennart
authors.initials: L
authors.lastname: Sanzén
authors.forename: Jack
authors.initials: J
authors.lastname: Besjakov
authors.forename: Ake
authors.initials: A
authors.lastname: Carlsson
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D002484:Cementation; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D010780:Photogrammetry; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation