There have been reports on the clinical survivorship of the Charnley Elite Plus (Depuy) hip prosthesis. We report the minimum five-year clinical and radiographic results of this implant in a consecutive series of one hundred and thirty-five primary cemented total hip replacements (THR) in one hundred and thirty-one patients. The mean age at operation was seventy-four years (range forty-one to ninety).

The operations were performed at a single centre by surgeons of different grades using the modular Charnley Elite Plus THR with CMW cement. The indications for surgery were osteoarthritis in 87% and rheumatoid arthritis in 13%.

The mean follow-up was five years four months (range five years to six years two months). At the most recent follow-up twenty-three patients had died and four patients were lost to follow up. Thirteen hips have been revised for femoral loosening. Eight of these were for aseptic loosening and five were infected. Ninety-five surviving hips were therefore available for review. Seventy were seen in clinic and twenty-five answered telephone questionnaires. Seventy sets of radiographs were available for assessment and of these a further three femoral components were radiographically loose.

Survivorship was calculated by constructing life tables using the end points of aseptic revision and definite radiographic loosening. Using this method the aseptic revision rate was found to be 7.26% at five years but if the radiological failures are included this becomes 10.15%.

Three different modes of failure were identified but there was no obvious single factor leading to what appears to be a high rate of aseptic failure.

The authors would suggest caution with selection of this implant until the clinical and radiological results of larger studies with a similar follow-up are reported.