Introduction: Aseptic loosening is the leading cause of failure in total hip arthroplasty. We present our long-term results of cemented revision of failed total hip replacements.

Materials And Methods: All patients requiring revision for aseptic loosening were prospectively followed up to assess the patterns of failure as well as the clinical and radiological outcomes of revision. There were 102 cases between 1992 and 2000. The mean age at revision was 67.4 (36–88). There were 60 male and 42 female patients. At the time of the final follow-up 26 patients had died and 10 had further surgery. Of the remainder, 64 patients attended the final assessment and 2 could not be traced.

Results: The mean time to follow-up was 6.8 years (5–13 years).

53 patients required revision of both components. There were 49 stem only revisions.

4 patients were re-revised for recurrent loosening and 2 for infection.

There were 14 dislocations. Of these, 4 required secondary stabilisation and 2 underwent Girdlestone’s excision arthroplasty for recurrent dislocation.

46 of the 64 patients who attended final follow-up had no changes in their X-ray appearances compared to the immediately post-operative films. 9 of the stems and 9 of the cups had signs of progressive lucent lines around the cement mantle.

This gives a survivorship of 89% at ten years with reoperation for any cause as the end-point.

Discussion: Initial reported results of cemented revisions were variable. These have been improving with more recent publications including those from the Scandinavian hip registries. Our results confirm the latter findings of excellent survivorship in cemented revisions.

Introduction: Patients’ demands from hip arthroplasty are changing. Bigger bearings with alternative bearing surfaces are marketed to meet these demands. The aim of this study is to investigate the level of function achieved by patients with the larger hard-on-hard hip replacements in the short term.

Methods: Three groups of patients were identified from the arthroplasty register. The two study groups were those who received a 36mm ceramic-on-ceramic hip replacement (28 patients) and those who received larger metal-on-metal hip replacements (56 patients). The control group (25 patients) was age matched patients receiving 28mm hip replacements with a polyethylene acetabular component.

All patients received postal questionnaires comprising the Oxford Hip Score, the HOOS score and a satisfaction score. Routine yearly radiological examination was also undertaken. Demographic data are shown in Table 1.

Results: All three groups showed significant improvement in the oxford hip score after hip arthroplasty. Those with the larger head sizes had significantly lower scores than those with 28mm.

Activity scores in the HOOS hip survey were not significantly different in the three groups.

There was no difference in satisfaction scores and whether patients would have the same operation again.

Discussion: Our findings suggest that in the short term, functional levels achieved following hip replacement are not influenced by the size of bearing. Should these results be reproduced in larger and longer term studies use of these costly implants may have to be questioned.