A retrospective review of 148 consecutive porous-coated hip arthroplasties (PCA) showed an incidence of thigh pain of 13% one year after surgery, and 22% at two years. Positive correlations were made with
We examined 59 cemented high density polyethylene sockets removed at revision hip arthroplasty. Of these 19 showed areas of wear between the outside of the socket and the acetabular bone. This was associated with lack of acrylic cement in those areas and was also related to the depth of the wear on the articulating surface of the socket. It is suggested that, in some cases, changes at the bone-cement junction are secondary to socket loosening and abrasion against the bone of the acetabulum, rather than to particles migrating from the metal-polyethylene interface. It is therefore important that impingement of the neck of the
A method is described of measuring radiological subsidence of a femoral prosthesis in relation to the femur after total hip arthroplasty. The method depends on measuring the distance from the tip of the femoral prosthesis to a fixed point in the bone. Subsidence after the use of a conventional design of
Nine uncemented hip prostheses of modular design were revised because of late infection (2 cases),
We present the results of 506 consecutive Howse hip arthroplasties with a minimum follow-up of 10 years. The mortality within one month of surgery was 0.79%. The early dislocation rate was 1.38%, two hips requiring revision. Nine hips developed deep sepsis (1.78%), eight of which required revision. At 10 years 42 hips (8.3%) had required revision, including 14 with aseptic acetabular loosening and 11 with
To assess the effect of improved methods of femoral cementing on the loosening rates in young patients, we reviewed 50 'second-generation' cemented hip arthroplasties in 44 patients aged 50 years or less. The
The purpose of this study was to determine the biological effects of the elastic modulus of the
The results of 140 total hip revision procedures for "non-septic" loosening, dislocation, and fracture of the
The newer techniques of cementing aim to improve interlock between cement and bone around a
We performed total hip replacement on 25 congenitally dislocated hips using corticocancellous bone from the femoral neck as a bone graft to reconstruct the deficient acetabulum. Two patients (two hips) died less than five years after surgery and three hips developed deep infection. We reviewed the remaining 20 hips at an average interval of 8.4 years (5.2 to 12.9). Their functional scores (modified Merle d'Aubigne and Postel) averaged 5.7 for pain, 5.1 for walking ability, and 4.2 for range of motion. Radiographs showed union and remodelling of the grafted bone in every case. There were radiological signs of aseptic loosening in three sockets (15%) without collapse of the grafted bone. None of the
We implanted 57 uncemented cobalt-chrome porous-coated collarless femoral components into 51 patients (mean age 49 years). At review, five to eight years postoperatively, good or excellent results were recorded in 70% by the Mayo Clinic hip evaluation and in 84% by the Harris hip score. Revision for aseptic loosening of the
Ten uncemented total hip replacements were performed in 1975 using an implant in which the cobalt-chrome
We report the clinical and tribological performance of 67 ceramic acetabular prostheses implanted between 1976 and 1979 without bone cement. They articulated with ceramic femoral heads mounted on mental
We reviewed 19 patients who presented with aggressive granulomatosis around the
Polyethylene liners of modular acetabular components wear sometimes need to be replaced, despite the metal shell being well fixed. Replacing the liner is a relatively simple procedure, but very little is known of the outcome of revision. We prospectively followed up 1126 Harris-Galante I metal-backed, uncemented components for between nine and 19 years. We found 38 (3.4%) liners of 1126 acetabular components wore and required revision. These revisions were then followed up for a mean of 4.8 years. The rate of dislocation was 28.9%. Nine of the dislocations occurred once and two were recurrent. The overall secondary revision rate was three of 38 total hip replacements (7.9%) at a mean follow-up of 4.8 years. This gives a 92.1% survivorship (35 of 38) at under five years. In isolated revision of a liner, we had a complication rate of 23% (three of 13). In revision of a liner combined with revision of the
We report a prospective study of the use of intramedullary bone blocks to improve the fixation of a matt-finish
We studied the risk of recurrent dislocation in 121 primary and 39 revision Charnley or Charnley hybrid total hip arthroplasties which had been treated for a primary dislocation between 1979 and 1995. Only 35% of these hips had no further dislocation or a revision for instability within one year. The rates of survival gradually declined with time or if a second, third or fourth dislocation occurred. The risk of recurrence was greater in men, but was not related to age, diagnosis, time of the first dislocation or whether the index operation had been a primary or a revision procedure. Operative treatment included 15 reoperations leaving intact components, 50 revisions, and permanent removal of the
We followed the first 354 consecutive implantations of a cementless, double-tapered straight
Radiostereometric analysis (RSA) studies of vitamin E-doped, highly crosslinked polyethylene (VEPE) liners show low head penetration rates in cementless acetabular components. There is, however, currently no data on cemented VEPE acetabular components in total hip arthroplasty (THA). The aim of this study was to evaluate the safety of a new cemented VEPE component, compared with a conventional polyethylene (PE) component regarding migration, head penetration, and clinical results. We enrolled 42 patients (21 male, 21 female) with osteoarthritis and a mean age of 67 years (Aims
Patients and Methods
Between March 1990 and May 1991 we performed 85 primary total hip replacements in 74 patients using the Landos Atoll hydroxyapatite (HA)-coated cup and the Corail HA-coated stem. The patients were followed up for a mean of ten years. Of the 85 cups, 26 (31%) have already been revised and a further six are radiologically unstable and awaiting revision. Two