Abstract
Purpose: To evaluate the outcome of the Elite Plus femoral stem in multiple surgeons’ hands at a minimum of three years post implantation, in accordance with guidelines published by the National Institute for Clinical Excellence.
Methods: Between March 1994 and March 1998, 199 patients underwent 224 primary total hip replacement procedures using the Elite Plus femoral stem at the Glenfield Hospital, Leicester. Seven different Consultant Orthopaedic Surgeons implanted these stems during this period. Patients were reviewed at a mean of 4.75 years following surgery using the Oxford Hip Score and plain radiographs. The mean age at operation was 62.3 years. Between March 1994 and March 2001, 12 patients underwent re-operation for all reasons, and 13 died. Oxford Hip Scores were returned from 159 patients (177 stems; 88.9%) and an AP and lateral radiograph obtained on 145 patients (162 stems; 81.4%)
Results: There were five known revision procedures for aseptic loosening (5/224; 2.2%). The mean Oxford Hip Score was 24 (range 10–54). Radiological assessment revealed gross failure in a further 11 femoral stems (11/162; 6.8%), and adverse radiological features in a further 28 stems (28/162; 17.3%)
Discussion: In the ‘best case’ scenario, a combined revision and radiographic failure rate of 9% is higher than expected. Antero-posterior positioning of the stem, resulting in bony cortical contact, appeared to produce a characteristic progressive osteolytic lesion which resulted in early implant failure. Additional possible modes of failure are discussed.
These abstracts were prepared by Mr Peter Kay. Correspondence should be addressed to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
