Aim: To assess the factors affecting cup survivorship in cemented Total Hip Replacements carried out for DDH.

Methods: A retrospective study of 292 cemented total hip replacements carried out at Wrightington. The hips were classified according to the Crowe and Hartofilakidis classifications. Revision was used as the end point for prosthetic survivorship. The results were analysed statistically using SPSS for Windows.

Results: The mean age at time of surgery was 42.6 years with a mean follow-up of 15.7 years. The acetabulum was grafted in 48 cases. The commonest cause for revision was aseptic loosening of the acetabular component (88.3%). There was a higher rate of premature failure of the acetabular component with increasing severity of hip dysplasia, especially after 10years. There was a correlation with age of the patient, accelerated socket wear and previous pelvic osteotomy. There were higher rates of failure with the Charnley CDH stem and the offset bore cup.

Conclusion: Factors having an adverse effect on cup survival are severity of hip dysplasia, younger age at time of primary surgery, accelerated polyethylene wear and previous pelvic osteotomy. Bone grafting of the acetabulum and the operating surgeon did not influence long term cup survival.

Aims: As part of the guidelines recommended by NICE (National Institute of Clinical Excellent), we are presenting the early results of this new hip replacement component.

Methods: We reviewed 65 consecutive primary total hip replacements in 59 patients in which the Opera Flanged cemented acetabular component (smith & nephew) had been used. The mean follow-up was 47 months (36 to 63). In all cases a Charnley femoral prosthesis had been used. There were 39 women and 26 men with a mean age at operation of 67.4 years (33 to 90). Survival analysis of the acetabular components was performed.

Results: Two components were revised due to deep infection, and one of these cups was discovered to be well fixed at operation. None of the acetabular components required revision for aseptic loosening. After 5 years survival was 97% using the worst-case scenario. Radiological analysis of all acetabular components at 12 months post-operation and at yearly intervals revealed no cases of aseptic loosening. Radiolucencies around the cemented socket were noted in five patients, but were not progressive on sequential radiographs.

Conclusions: The early results are encouraging and the follow-up will be continued to assess the 10 years results.