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The Journal of Bone and Joint Surgery (American) 85:1066-1072 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Twenty-five-Year Results After Charnley Total Hip Arthroplasty in Patients Less than Fifty Years Old

A Concise Follow-up of a Previous Report*

Jay D. Keener, MD, John J. Callaghan, MD, Devon D. Goetz, MD, Douglas R. Pederson, PhD, Patrick M. Sullivan, MD and Richard C. Johnston, MD

Investigation performed at the Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, and Iowa Methodist Medical Center, Des Moines, Iowa

Jay D. Keener, MD
John J. Callaghan, MD
Douglas R. Pederson, PhD
Richard C. Johnston, MD
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242. E-mail address for J.J. Callaghan: john-callaghan{at}uiowa.edu

Devon D. Goetz, MD
Patrick M. Sullivan, MD
Des Moines Orthopedic Surgeons, 6001 Westown Parkway, Des Moines, IA 50266

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from National Institutes of Health Grants AR43314 and AR47653, National Institutes of Health Bioengineering Research Partnership Grant AR46601, Veterans Administration Merit Award, and DePuy. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from commercial entities (Zimmer and DePuy). Also, commercial entities (Zimmer and DePuy) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

*Original Publication
Callaghan JJ, Forest EE, Olejniczak JP, Goetz DD, Johnston RC. Charnley total hip arthroplasty in patients less than fifty years old. A twenty to twenty-five-year follow-up note. J Bone Joint Surg Am. 1998;80:704-14.

Abstract: We report the updated results for a previously evaluated cohort of patients who were less than fifty years old when they underwent Charnley total hip arthroplasty with cement. The original cohort consisted of ninety-three total hip arthroplasties performed in sixty-nine patients. The patients were followed for a minimum of twenty-five years after surgery or until death. The present report describes the findings of the radiographic and functional follow-up, which was performed for forty-two of the forty-three living patients.

At the time of the latest follow-up, twenty-nine (31%) of the ninety-three total hip replacements had been revised or removed. Eighteen acetabular and five femoral components were revised secondary to aseptic loosening. The combined prevalence of radiographic failure or revision because of aseptic loosening was 13% for the femoral components and 34% for the acetabular components. Comorbid medical conditions significantly hindered results on each functional subscale (p < 0.05).

This study demonstrates the durability of cemented total hip replacements in a young patient population. Sixty-nine percent of the original hip replacements were functioning well at the latest follow-up examination or at the time of death, and only 5% required more than one revision arthroplasty.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


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