title: Outcomes of Charnley total hip arthroplasty using improved cementing with so-called second- and third-generation techniques.
abstract: BACKGROUND
  Techniques of cemented total hip arthroplasty have developed over time. We present the outcomes of Charnley total hip arthroplasty performed using improved second- and third-generation cementing techniques.
  
  
  METHODS
  We reviewed the radiologic results of 91 Charnley total hip arthroplasties performed using second- and third-generation cementing techniques. Second-generation techniques involved making multiple anchor holes, a double-cementing method on the acetabular side and an intramedullary plug, and retrograde filling with a cement gun on the femoral side in 57 hips. Third-generation techniques involved additional vacuum mixing and cement pressurization in 34 hips.
  
  
  RESULTS
  Joint survival rates at 20 years when using second-generation techniques were 89% for the socket and 94% for the stem with aseptic loosening as the end point; the survival rates at 10 years when using third-generation techniques were 97 and 100%, respectively. According to our radiographic evaluation system for the clear zone at 5 years, there was less clear zone in the acetabular side with the third-generation techniques than with second-generation techniques. In the femoral side, there was very little development of the clear zone, but the difference between generations was not significant.
  
  
  CONCLUSIONS
  Second- and third-generation cementing techniques showed excellent survivorship. The clear zone scores at 5 years indicated that third-generation techniques were effective, especially in the acetabular side, and may produce better long-term results than second-generation techniques.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Aichi Medical University, 21 Karimata Yazako, Nagakute-cho, Aichi, Japan. shiro@aichi-med-u.ac.jp
authors.forename: Shiro
authors.initials: S
authors.lastname: Hirose
authors.forename: Hiromi
authors.initials: H
authors.lastname: Otsuka
authors.forename: Takkan
authors.initials: T
authors.lastname: Morishima
authors.forename: Keiji
authors.initials: K
authors.lastname: Sato
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D002484:Cementation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements