The Journal of Bone and Joint Surgery (American). 2006;88:1481-1485.
doi:10.2106/JBJS.E.00818
© 2006 The Journal of Bone and Joint Surgery, Inc.
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 Adult Hip Reconstruction Test 21: Fall 2006 (publication date November 15, ...
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Results of Charnley Total Hip Arthroplasty with Use of Improved Femoral Cementing Techniques

A Concise Follow-up, at a Minimum of Twenty-five Years, of a Previous Report*

Andrea E. Buckwalter, BS1, John J. Callaghan, MD1, Steve S. Liu, MD1, Douglas R. Pedersen, PhD1, Devon D. Goetz, MD2, Patrick M. Sullivan, MD2, Jessica A. Leinen, BS1 and Richard C. Johnston, MD1

1 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
2 Des Moines Orthopaedic Surgeons, 6001 Westown Parkway, Des Moines, IA 50266

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

Madey SM, Callaghan JJ, Olejniczak JP, Goetz DD, Johnston RC. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg Am. 1997;79:53-64. Erratum in: J Bone Joint Surg Am. 1997;79:635. Klapach AS, Callaghan JJ, Goetz DD, Olejniczak JP, Johnston RC. Charnley total hip arthroplasty with use of improved cementing techniques: a minimum twenty-year follow-up study. J Bone Joint Surg Am. 2001;83:1840-8.

In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from DePuy, the Orthopaedic Research and Education Foundation's Medical Student Summer Orthopaedic Research Fellowship, University of Iowa Roy J. and Lucille A. Carver College of Medicine's Summer Research Fellowship, and National Institutes of Health Grants R01 AR47653 and AR46601. 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 (DePuy and Zimmer). Also, a commercial entity (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 Publications

The current study was performed to determine the status, at a minimum of twenty-five years, of a prospective, single-surgeon series of patients treated with primary Charnley total hip arthroplasty with a contemporary femoral cementing technique that included use of a distal cement plug and a retrograde cement-delivery system. Since our review at a minimum of twenty years postoperatively, two primary total hip prostheses were revised (one because of acetabular loosening, and one because of femoral loosening). Of the original cohort of 357 hips (320 patients), ten (2.8%) had revision of the femoral stem because of aseptic loosening. Forty-nine patients (fifty-two hips, 14.6%) who had been in the initial study group were still living at the time of the present review. Five hips (10%) in living patients had required a femoral revision because of aseptic loosening. Including those that were revised, eight femoral components (17%) in living patients were seen to be loose radiographically. Although this study demonstrates the remarkable durability of the femoral fixation obtained with the polished flatback Charnley prosthesis and the contemporary cementing technique, there was some deterioration of the results with time. These results provide a standard for comparison with cementless fixation after hips treated with that technique have been followed for a similar duration.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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