title: Long-term outcome of total hip replacement in patients with or without femoral head contamination.
abstract: OBJECTIVE
  To compare long-term outcomes of total hip replacement (THR) in patients with or without contamination of the femoral head.
  
  
  METHODS
  After a mean period of 12 (range, 8-17) years, 104 female and 71 male THR patients aged 47 to 96 (mean, 77) years were reassessed via a self-administered questionnaire, and 25 other THR patients were reassessed by review of case notes. The questionnaires comprised the 12-item Oxford hip score and the European Quality Of Life (EuroQOL). 87 and 88 patients had positive and negative cultures in the donated femoral heads, respectively. The 2 groups were compared with respect to the Oxford hip score, the EuroQOL, and rates of complication and revision surgery.
  
  
  RESULTS
  Long-term outcomes of THR patients with or without femoral head contamination were not significantly different. Respectively, the mean Oxford hip scores were 36 and 39 (p=0.4); 16 and 14 patients had the maximum score of 48; 2 and 3 patients scored <10 (mostly owing to aseptic loosening). The respective mean visual analogue scale score of the EuroQOL were 65 and 73 (p=0.07); only the dimension of self care was significantly different between groups (p=0.04). Respectively, 14 and 12 patients had complications (16% vs. 15%, χ²=0.05, p=0.8), whereas 11 and 5 patients had revision surgery (13% vs. 6%, χ²=2.2, p>0.1).
  
  
  CONCLUSIONS
  Microbiological screening of donated femoral heads plays no role in predicting long-term failure of THR in the donors.
authors.affiliation: Division of Orthopaedic Surgery, University of Leicester, Leicester, United Kingdom. ti11@le.ac.uk
authors.forename: Talal
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Mayyar Ghazal
authors.initials: MG
authors.lastname: Aswad
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Dias
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Brown
authors.forename: Colin N
authors.initials: CN
authors.lastname: Esler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D004866:Equipment Contamination; D019544:Equipment Failure Analysis; D005260:Female; D005270:Femur Head / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011788:Quality of Life; D012086:Reoperation; D014184:Transplantation, Homologous; D016896:Treatment Outcome