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Cemented Charnley Total Hip Replacements Durable Over 30 Years

Primary Charnley total hip replacements fixed with cement show remarkable durability over 30 years, report researchers from the United States.

Long-term data continue to confirm the good results reported at earlier follow up at 2, 10, 15, and 25 years of a prospective study of 330 primary cemented Charnley total hip replacements in 262 patients done between July 1970 and April 1972.

In this current analyses, John J. Callaghan, MD, and colleagues, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, describe outcomes of this patient cohort that was followed for a minimum of 30 years after primary Charnley total hip replacement. Of the 262 patients originally enrolled in the study, 234 are dead and 1 was lost to follow-up The remaining 27 - 8 men and 19 women, average age at follow up 84.11 years - (34 hips) are the focus of this long-term update.

At 30-year follow-up, the original component was retained in 23 of the 34 hips. For the 11 hips that underwent revision or resection arthroplasty, 8 were for aseptic loosening and 3 for infection. At least 1 dislocation occurred in 6 hips during the 30 years.

Clinical evaluation based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a questionnaire showed that, compared to normative values, patients reported significantly lower subscores for pain (2.9 vs. 0.01 of 20 points, respectively; P = .006), stiffness (2.7 vs. 0.40 of 8 points, respectively; P = .002), and physical function (24.1 vs. 1.8 of 68 points, respectively; P = .0002). Revision due to aseptic acetabular loosening was significantly associated with a lower physical function score (P = .027).

Radiologic evaluation showed probable or definite aseptic loosening of the acetabular component in 14 hips (8 of which underwent revision) and of the femoral component in 6 hips (3 of which were revised).

Based on these updated results, total hip replacements were still intact or had been intact prior to the patients' death in 88% of the full cohort of 329 patients at 30-year follow-up. The authors conclude that "these results should provide a benchmark with which to compare the long-term results of current total hip arthroplasties."

J Bone Joint Surg Am 2004 Apr;86:4:690-695. "Results of Charnley Total Hip Arthroplasty at a Minimum of Thirty Years. A Concise Follow-up of a Previous Report"

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