The Journal of Bone and Joint Surgery (American). 2009;91:2846-2851.
doi:10.2106/JBJS.H.00018
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Charnley Low-Friction Arthroplasty in Young Patients with Osteoarthritis

Outcomes at a Minimum of Twenty-two Years

George Georgiades, MD1, George C. Babis, MD2 and George Hartofilakidis, MD3

1 Orthopaedic Department, Tripoli Hospital, 31 Kousianofsky Street, N. Psychiko, Athens 11525, Greece. E-mail address: gegeorgiades{at}yahoo.com
2 First Orthopaedic Department, University of Athens Medical School, 5 Heraklitou Street, Dionysos, Athens 14576, Greece. E-mail address: gebabis{at}med.uoa.gr
3 University of Athens Medical School, 21 Fotiou Patriarchou Street, Athens 11471, Greece. E-mail address: geo{at}hart7.com

Investigation performed at the First Orthopaedic Department, University of Athens Medical School, Athens, Greece

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: We previously reported the outcomes at a minimum of twelve years after eighty-four Charnley low-friction arthroplasties performed in patients with osteoarthritis who were less than fifty-six years old at the time of the surgery. We now update the results of that cohort at a minimum of twenty-two years postoperatively.

Methods: Eighty-four hips (in sixty-nine patients) with osteoarthritis, which was secondary to congenital hip disease in sixty-four (76%) of them, were followed prospectively with use of the Merle D'Aubigné and Postel scoring system as modified by Charnley and with serial radiographs.

Results: At the time of the latest follow-up, thirty-seven hips (44%) had failed. Twenty-eight acetabular and thirty femoral components, in a total of thirty-two hips, had been revised because of aseptic loosening; six of the loose femoral components were broken. Three hips were infected and were converted to a resection arthroplasty. A periprosthetic femoral fracture occurred in two additional hips, three and ten years postoperatively, and both were treated with internal fixation. Thirty-seven original acetabular components and thirty-six original femoral components were in place for an average of twenty-nine years. The probability of survival for both components, with failure for any reason as the end point, was 0.51 (95% confidence interval, 0.39 to 0.62) at twenty-five years.

Conclusions: These long-term results can be used as a benchmark with which to compare outcomes of different designs when total hip arthroplasty is performed in young patients when the majority have congenital hip disease.

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


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