We aim to report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong HAC coated femoral and acetabular components.

We reviewed 586 consecutive cementless primary THA in 542 patients with a minimum 12-18 year follow-up, performed at one institution between 1986 and 1994. Twenty-eight (32 THA) were lost to follow-up. Clinical outcome was measured using Harris, Charnley and Oxford scores. Quality of life using EuroQol

EQ-5D. Radiographs were systematically analysed.

The mean age was 75.2 years. Dislocation occurred in 12 patients (three recurrent). Re operations were performed in 11 patients (1.9%). Four acetabular and one stem revisions were performed for aseptic loosening. Other re-operations were for infection (two), periprosthetic fractures (two), cup malposition (one), revision of worn liner (two). The mean Harris and Oxford scores were 89 (79–96) and 18.4 (12–32) respectively. The Charnley score was 5.7 for pain, 5.3 for movement and 5.4 for mobility. Acetabular radiolucencies were present in 54 hips (9.7%).

The mean linear polythene wear was 0.06 mm/year. Stable stem by bony ingrowth was identified in all hips excluding one femoral revision case. Mean stem subsidence was 2.2mm (0.30–3.4mm). Radiolucencies were present around 37 (6.6%) stems. EQ- 5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, survival at 12 years was 96.1% for acetabular and 98.3% for femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 97.2%.

The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long-term period.

We report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong Hydroxyapatite ceramic (HAC) coated acetabular components.

We reviewed 412 consecutive cementless primary THA using fully coated acetabular shell in 392 patients—with a minimum 12 to 18 year follow-up—performed at two institutions between 1986 and 1994. Twenty (22 THA) were lost prior to 12-year follow-up, leaving 372 patients (390 THA) available for study. Fully HAC coated stems were used in all patients. The clinical outcome was measured using Harris, Charnley and Oxford hip scores and the quality of life using EuroQol EQ-5D. Radiographs were systematically analysed for implant position, loosening, migration, osteolysis. Polythene wear was digitally measured. The radiographic stability of the acetabular component was determined by Enghs criteria.

The mean age was 74.4 years. The mean Harris and Oxford scores were 87 (78– 97) and 19.1 (12–33) respectively. The Charnley score was 5.6 (5-6) for pain, 5.2 (4–6) for movement and 5.3 (4–6) for mobility. Migration of acetabular component was seen in four hips. Acetabular radiolucencies were present in 54 hips (9.7%). The mean linear polythene wear was 0.06mm/year. Mean inclination was 48.4° (38–65).

Radiolucencies were present around 37 (6.6%) stems. Dislocation occurred in 10 patients (three recurrent). Re-operations were performed in nine patients (1.9%). Four acetabular revisions were performed for aseptic loosening. Other re-operations were for infection (three), periprosthetic fractures (one), cup malposition (one) and revision of worn liner (three). Mean EQ-5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 97.1% for acetabular component. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 96.2%.

The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long-term period.

BACKGROUND

In our institution we use the Winklestabile volar locking plate for operative fixation of distal radius fractures. This study aims to assess subjective and objective outcomes using this method of treatment.

Introduction

We aim to report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong HAC coated femoral and acetabular components.

We aim to report the clinical, radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong Hydroxyapatite ceramic coated acetabular components. We reviewed 412 consecutive primary THA using fully coated acetabular shell in 392 patients, with minimum 12-year follow-up to 18 years, performed at two institutions. Twenty (22 THA) were lost prior to 12-year follow-up, leaving 372 patients (390 THA) available for study.

Fully HAC coated stems were used in all patients. Clinical outcome was measured using Harris, Charnley Oxford, EuroQol EQ-5D scores. Radiographs were systematically analysed for implant position, loosening, migration, osteolysis. Polythene wear was digitally measured.

Mean age was 74.4 yrs. Dislocation occurred in 10 patients (3 recurrent). Revision operations were performed in nine patients (1.9%). Four acetabular revisions were performed for aseptic loosening. Other re-operations were for infection (3), periprosthetic fractures (1), cup malposition (1), revision of worn liner (3). The mean Harris and Oxford scores were 87 (78–97) and 19.1 (12–33) respectively. The Charnley score was 5.6 (5–6) for pain, 5.2 (4–6) for movement and 5.3 (4–6) for mobility. Migration of acetabular component was seen in 4 hips. Acetabular radiolucencies were present in 54 hips (9.7%). The mean linear polythene wear was 0.06mm/year. Mean inclination was 48.4 deg(38–65). Mean EQ-5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 96.1%. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 94.2%.

The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long term period

Aim: To report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong Hydroxyapatite ceramic (HAC) coated femoral and acetabular components

Methods: We reviewed 586 consecutive cementless primary THA using HAC coated components in 542 patients, with a minimum 12-year follow-up to 18 years, performed at one institution between 1986 and 1994. Twenty eight (32 THA) were lost prior to 12-year follow-up, leaving 514 patients (554 THA) available for study. Threaded cups were used in 64% and press-fit cups with screws in the rest. Fully HAC coated stems were used in all patients. The clinical outcome was measured using Harris, Charnley and Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS) and quality of life using EuroQol EQ-5D. Radiographs were systematically analysed for implant position, loosening, migration, osteolysis and stress shielding. Polythene wear was digitally measured. The radiographic stability of the femoral component was determined by Enghs criteria

Results: The mean age was 75.2 yrs. Dislocation occurred in 12 patients (3 recurrent). Re operations were performed in 11 patients (1.9%). Four acetabular and one stem revisions were performed for aseptic loosening. Other re-operations were for infection (2), periprosthetic fractures (2), cup malposition (1), revision of worn liner (2). The mean Harris and Oxford scores were 89 (79–96) and 18.4 (12–32) respectively. The Charnley score was 5.7 (5–6) for pain, 5.3 (4–6) for movement and 5.4 (4–6) for mobility. Migration of acetabular component was seen in 4 hips. Acetabular radiolucencies were present in 54 hips (9.7%). The mean linear polythene wear was 0.06mm/year. Stable stem by bony ingrowth was identified in all hips excluding one femoral revision case. Mean stem subsidence was 2.2mm (0.30–3.4mm). Radiolucencies were present around 37 (6.6%) stems. Mean EQ- 5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 96.1% for acetabular and 98.3% for femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 97.2%.

Conclusion: The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long term period.

Purpose: We report the clinical and radiological outcome of revision of cemented hip arthroplasties using Hydroxyapatite ceramic (HAC) coated femoral and acetabular components.

Methods: 86-revision hip arthroplasties were performed in 82 patients with JRI Furlong HAC coated femoral and acetabular components. 2 surgeon series. The patients were followed for a mean 12.6 years (7–15). The femoral component was revised in all hips and the ace-tabular cup was revised in 62 hips (72%). Threaded cup used in 37 (59%) patients and press fit cups with screws in the rest. Acetabular bone grafting was performed in 24 (38%) hips. The clinical outcome was measured using Harris, Charnley, Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS). The quality of life was assessed using EuroQol EQ-5D.

Results: The mean age was 78.2 yrs. The mean time to revision was 96 months. None lost to follow up. 11 patients died. Dislocation was seen in 2 patients (1 recurrent). 2 hips were infected (1 re revision, 1 excision arthroplasty). Cup liner revised in 1 patient. The mean Harris and Oxford scores were 82 (59 96) and 24.4 (12–52) respectively. The Charnley score was 5.0 (3–6) for pain, 4.9 (3–6) for movement and 4.4 (3–6) for mobility. Migration of acetabular component was seen in 2 (4%) hips. Acetabular radiolucencies were present in 26 hips (41%) The mean linear polythene wear was 0.05mm/year. Mean stem subsidence was 1.6mm (0.30– 2.4mm). Radiolucencies were present around 21 (33%) stems. Stress shielding was seen in 40 of 56 stems. Calcar resorption was seen in 11 stems (16%). Bony ingrowth was seen in 76(89%) of stems. Ectopic calcification was seen in 12 (19%) hips. Of the 3 hips re- revised, 2 were for deep sepsis and 1 for recurrent dislocation. Mean EQ- 5D description scores and health thermometer scores were 0.69 (0.51–0.89) and 79 (54–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 95.1% (95% CI =2.7),96.3% (95% CI = 2.1) for acetabular and femoral components respectively. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 93% (95% CI= 2.3).

Conclusion: The results of this study support the continued use of this prosthesis and document the durability of the HAC coated components. Our study had fewer cases of loosening of the components and had a better survival than bipolar implants or cemented acetabular components

Introduction and Aims: We report the clinical/radiological outcome of revision of cemented hip arthroplasties using Hydroxyapatite ceramic (HAC) coated femoral and acetabular components

Method: Sixty revision hip arthroplasties were performed in 64 patients with JRI Furlong HAC coated femoral and acetabular components. Mean follow-up was 10 years. Clinical outcome was measured using Harris, Charnley and Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS) and quality of life using EuroQol EQ-5D.

Results: The mean age was 78 years. The mean time to revision was 96 months. Eleven died to causes unrelated to index revision. Mean Harris and Oxford scores were 82 and 24.4. The Charnley score was 5.0 for pain, 4.9 for movement and 4.4 for mobility. Migration > 4mm of the acetabular component was seen in two hips. Acetabular radiolucencies were present in 26 hips. Mean linear polythene wear was 0.05mm/year. The mean subsidence was 1.6mm. Radiolucencies were present around 21 stems. Stress shielding was seen in 40; calcar resorption in 11; and endosteal cavitation around two stems. Ectopic calcification was seen in 12 hips. Three hips were re-revised – two for deep sepsis, one for recurrent dislocation. Mean EQ- 5D description and health scores were 0.69 and 79 (p> 0.05). With failure defined as repeat revision because of aseptic loosening, the rate of survival at 12 years was 100% for acetabular and femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 93% (95% CI ± 2.3).

Conclusion: The results of this study support the continued use of this prosthesis and document the durability of the HAC coated components, with fewer cases of loosening of the components, and a better survival than bipolar implants or cemented acetabular components. As loosening can occur as a late phenomenon, a longer follow-up is needed to determine the longevity of the HAC coated prosthesis.

Purpose: We report the clinical and radiological outcome of revision of cemented hip arthroplasties using Hydroxyapatite ceramic (HAC) coated femoral and acetabular components.

Patients and Methods: 66-revision hip arthroplasties were performed in 64 patients with JRI Furlong HAC coated femoral and acetabular components. The patients were followed for a mean 10.6 years (7–15). The femoral component was revised in all hips and the acetabular cup was revised in 52 hips (79%). The clinical outcome was measured using Harris, Charnley and Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS). The quality of life was assessed using EuroQol EQ-5D. All pre op, immediate post op and last follow up radiographs were analysed for ace-tabular and femoral component loosening.

Results:The mean age was 78.2yrs (58–89yrs). The mean time to revision of the primary hip replacement was 96 months (24 to 161). 11 patients died due to causes unrelated to the index revision. At last follow up, the mean Harris and Oxford hip scores were 82 (59 – 100) and 24.4 (12-52) respectively. The Charnley score was 5.0 (3-6) for pain, 4.9 (3-6) for movement and 4.4 (3-6) for mobility. Acetabular bone grafting was performed in 26 (50%) hips. Migration > 4mm of the acetabular component was seen in 2 (4%) hips. Acetabular radiolucen-cies were present in 26 hips (55%). The mean linear polythene wear was 0.05mm/year. The mean stem subsidence was 1.6mm (0.30- 2.4mm). Radiolucencies were present around 21 (33%) stems. Stress shielding was seen in 40 of the 56 stems. Calcar resorption was seen in 11 stems (16%). Endosteal cavitation was seen around 2 stems. Ectopic calcification was seen in 12 (19%) hips. Of the 3 hips re- revised, 2 were for deep sepsis and 1 for recurrent dislocation. The mean EQ- 5D description scores and health thermometer scores were 0.69 (0.51-0.89) and 79 (54-95) respectively (p> 0.05 for both scores compared to average UK population scores). With failure defined as repeat revision because of aseptic loosening, the rate of survival at 12 years was 100% for the acetabular and femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 93% (95% CI ± 2.3).

Conclusion:The results of this study support the continued use of this prosthesis and document the durability of the HAC coated components. Our study had fewer cases of loosening of the components and had a better survival than bipolar implants or cemented acetabular components. As loosening can occur as a late phenomenon, a longer follow up is needed to determine the longevity and durability of the HAC coated prosthesis.

Introduction: There are more than 60 different hip prostheses currently available for total hip replacement (THR). Cemented prostheses make up about 90 to 95% of current total UK market. The cost of THR prosthesis varies widely with some prostheses cost 5 times more than others. Furlong Stainless steel cemented is a low-cost prosthesis that has been used in few hospitals in UK and Europe. There is no published data to report its survival and performance. Aim: To evaluate the outcome of a low-cost THR prosthesis (Furlong stainless steel) that has been in use in our hospital since 1993. Patients and Methods: we retrospectively reviewed 142 THR performed between 1993 and 2001. The average age was 72 and osteoarthritis was the primary pathology in 92%. Operations were performed by different grades of surgeons. 25 patients were dead at the time of the study. Results: 4 cases underwent revision (2.8%) with survival rate of 97.2%. 6 cases of dislocation, 17 cases of heterotopic calcifications, 5 cases of DVT and one neurological injury. 88% reported no pain and 79.6% were satisfied. Conclusions: The results of this study compare favourably with Furlong Titanium cemented prosthesis and other popular THR prostheses (e.g. Charnley). It is rational to continue using this prosthesis, which appears to be cost effective.

The results of triple arthrodesis performed in 80 feet and followed for an average of 13 years are reviewed. Although the majority of patients were very pleased, the results of objective assessment were less favourable. There was a high incidence of degenerative joint changes in the ankle and midfoot and also of pseudarthrosis, avascular necrosis of the talus and residual deformity. Pre-operative rigid equinovarus deformity produced the majority of the poor results. It is suggested that bony resection alone might not be the best means of correcting severe equinus.

The effect of the pneumatic tourniquet on the incidence of postoperative deep venous thrombosis is uncertain. We carried out a controlled study comparing the incidence of deep venous thrombosis when a tourniquet was used with the incidence when a tourniquet was not used. Thrombosis was detected by radioisotope venography. The results of the study showed no difference in incidence and we concluded that the pneumatic tourniquet has no influence on the formation of a thrombus in a deep vein.