title: Medium-term result of Elite Plus hip arthroplasty: the second modular evolution of the original Charnley low-friction arthroplasty.
abstract: BACKGROUND
  The Elite Plus total hip arthroplasty (THA) system was introduced as the second modular evolution of the original Charnley low-friction arthroplasty. However, the results of the Elite Plus THA are currently considered to be inconsistent. The aim of this study was to clarify the medium-term results and the factors affecting the results of Elite Plus THA.
  
  
  METHODS
  The results of 97 Elite Plus THAs in 87 patients at 5 years or more postoperatively were reviewed. The patients' mean age was 65 years, and follow-up averaged 8.0 years. The Elite Plus stem was used in all hips, and three designs of socket, Hylamer Ogee in 40 hips, Wroblewski Offset Bore in 38, and Charnley Ogee in 19, were implanted. The survival rates with loosening and revision as endpoints were analyzed. To clarify the risk factors affecting the survival rates, Charnley's functional classification, Bombelli's classification, Crowe's classification, structural bone grafting of the acetabulum, cup design, stem position, and grading of the cement mantle were evaluated.
  
  
  RESULTS
  
  
  
  CONCLUSIONS
  The results of Elite Plus stem THA were excellent in the medium term. The cup design was a potential confounding factor for acetabular loosening, and the Hylamer Ogee socket was associated with a poor result.
authors.affiliation: Department of Orthopaedics, Japanese Red Cross Sendai Hospital, Sendai, Japan. taichi.irie@gmail.com
authors.forename: Taichi
authors.initials: T
authors.lastname: Irie
authors.forename: Masamizu
authors.initials: M
authors.lastname: Oyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kita
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kanichi
authors.initials: K
authors.lastname: Funayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D017276:Friction; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012307:Risk Factors; D013997:Time Factors