Charnley low-friction arthroplasty in teenage patients THE ULTIMATE CHALLENGE

The John Charnley Institute Wrightington Hospital, Wigan WN6 9EP, UK.
The Bone & Joint Journal (Impact Factor: 3.31). 04/2010; 92(4):486-8. DOI: 10.1302/0301-620X.92B4.23477
Source: PubMed

ABSTRACT Increasing follow-up identifies the outcome in younger patients who have undergone total hip replacement (THR) and reveals the true potential for survival of the prosthesis. We identified 28 patients (39 THRs) who had undergone cemented Charnley low friction arthroplasty between 1969 and 2001. Their mean age at operation was 17.9 years (12 to 19) and the maximum follow-up was 34 years. Two patients (4 THRs) were lost to follow-up, 13 (16 THRs) were revised at a mean period of 19.1 years (8 to 34) and 13 (19 THRs) continue to attend regular follow-up at a mean of 12.6 years (2.3 to 29). In this surviving group one acetabular component was radiologically loose and all femoral components were secure. In all the patients the diameter of the femoral head was 22.225 mm with Charnley femoral components used in 29 hips and C-stem femoral components in ten. In young patients who require THR the acetabular bone stock is generally a limiting factor for the size of the component. Excellent long-term results can be obtained with a cemented polyethylene acetabular component and a femoral head of small diameter.

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    ABSTRACT: Aseptic loosening of the acetabular component continues to be the most common indication for revision of total hip replacements in younger patients. Early in the evolution of the cemented hip, arthroplasty surgeons switched from removal to retention of the acetabular subchondral bone plate, theorizing that unfavourable mechanical forces were the cause of loosening at the bone-cement interface. It is now known that the cause of aseptic loosening is probably biological rather than mechanical and removing the subchondral bone plate may enhance biological fixation of cement to bone. With this in mind, perhaps it is time to revive removal of the subchondral bone as a standard part of acetabular preparation.
    The Bone & Joint Journal 04/2011; 93(4):435-8. DOI:10.1302/0301-620X.93B4.25642 · 3.31 Impact Factor
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    The Bone & Joint Journal 12/2012; 94(12):1618-24. DOI:10.1302/0301-620X.94B12.29124 · 3.31 Impact Factor
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