Purpose: We report the clinical and radiological outcome observed with Charnley total hip arthroplasties in a series of patients aged less than 60 years followed for at least 25 years.

Material and methods: This retrospective analysis included 141 consecutive total hip arthroplasties performed between 1972 and 1975 with a Charnley implant. The same surgeon used the same technique for all implants. All of these patients had been followed regularly for at least 25 years. We recorded radiographic measures of polyethylene cup wear and its impact on prosthesis life. We tested the influence of different factors on the development of femoral or acetabular loosening. Survival curves were calculated for acetabular and femoral components.

Results: At last follow-up 28 prostheses were still in place, 44 had undergone revision, 42 were lost to follow-up and 27 patients had died. At last follow-up, including the revised hips, joint function was considered, good, very good or excellent in 86% of the cases (merle d’Aubigné score 15 – 18 points). Polyethylene wear was 0.12 mm/year. Merkel osteolysis was observed in 50% of the cases.

Discussion and conclusion: This work demonstrates the good functional outcome provided by Charnley total hip arthroplasty. The wear and loosening rates were higher than observed in older patients. Prognosis depends on polyethylene wear and its biological consequences.