Cementless total hip replacements (THR) have a theoretical advantage over cemented designs in that bone lysis and probably aseptic loosening are less common complications. NICE guidelines suggest that prosthesis should have an aseptic loosening rate of < 10% at 10 years. Long-term follow-up of the Joint Replacement Instrumentation (JRI) Hydroxyapatite coated (HAC) Furlong system is gradually emerging following its first clinical application in 1985.

A retrospective study was performed to identify all patients having undergone a primary JRI HAC THR under a single Consultant at Barnsley Foundation Hospital NHS Trust between 1985 and 1995. This identified 124 joints in 106 patients (52% males). All living patients were sent a modified Oxford Hip Score questionnaire; case notes were also reviewed to identify any revision surgeries.

Median age at operation was 54.0 years. 17 patients (16%) had died at the time of this study. Median follow-up was 13.7 years (range 9.4–18.5 years). For 30 patients (24.2%) it was impossible to gather data on the survival of the hip.

Mean survival of all hips followed up was 16.2 years. Twenty-four hips (19.4%) required revision surgery; the median time to this surgery was 10.2 years, mean 8.2 years. Reasons included aseptic loosening of the stem in one patient at 12.7 years, aseptic loosening of the cup in 7 patients (range 10.2–17.4 years), worn polythene insert in 4 patients, infective loosening in 3 patients and recurrent dislocations in 2 patients. The remainder of revisions were for unknown reasons.

The Oxford Hip Score postal questionnaire was returned by 79% of patients. Mean score was 12.6/45 but 88% of patients reported overall satisfaction with the hip.

In summary, there were no revision surgeries at ten-year follow-up for aseptic loosening.

The results of 75 total hip replacements in 42 children with juvenile chronic arthritis are reported after a mean follow-up of 5.4 years. Their ages ranged from 11 to nearly 17 years at operation and many had active disease. Severe pain and marked stiffness of the hips were limiting their independence. At least half of the children were still growing and continued to grow after operation. The patients were carefully selected and gratifying results were obtained, but pre-operative assessment and overall supervision by a rheumatologist are important. Technical difficulties related to the size and maldevelopment of the hip are discussed. There was no infection and the single case of loosening of a femoral component after nine years has been successfully revised.