Charnley reported the 4- to 7‑year results of low‑friction total hip replacement with a high‑density polyethylene socket used as a primary operation.
Single‑center series of 379 primary hip replacements done from November 1962 to December 1965 and followed 4 to 7 years, with early complications reported for 582 operations.
Methods
Design
Single‑center case series
Operations November 1962 to December 1965
Patients
379 primary hip replacements followed ≥ 4 years
582 operations analyzed for early complications
Osteoarthritis in 70%
Rheumatoid arthritis in most of the rest
Treatment
Low‑friction total hip replacement
22 mm metal femoral head
High‑density polyethylene socket
Socket cemented (210) or press‑fit (169)
Follow-up
4 to 7 years
Outcomes
Pain and walking rated on a 1 to 6 scale
Range of movement
Mechanical failure
Infection
Key Findings
Mean final rating was 5.9 on the 1 to 6 scale for both pain relief and walking, with 90% graded excellent (Grade 6) and 10% good (Grade 5).
Only 2 of 210 cemented sockets loosened (1%), vs 11 mechanical failures among 169 press‑fit sockets (6.5%).
No femoral component loosened in any of the 582 hips.
Infection occurred in 3.8% of 582 hips (22), with 9 recognized in hospital and 13 (2.2%) appearing months or years later.
The author judged that the late infection findings tended to exonerate cement as a cause.
Range of movement improved in every hip but depended heavily on the preoperative range, and about 1 in 4 of the stiffest hips regained 90° of flexion.
Board pearl
In 7 sockets retrieved at post‑mortem, polyethylene wear averaged 0.13 mm per year, ranging from none in 6.5 years to 0.7 mm in 3 years.
Authors' conclusion
Apart from failures due to infection, the rate of which in the era under review was 3·8 per cent, late failures from mechanical causes were unusual after total hip replacement by this technique.
Charnley reported the 4- to 7‑year results of low‑friction total hip replacement with a high‑density polyethylene socket used as a primary operation.
Single‑center series of 379 primary hip replacements done from November 1962 to December 1965 and followed 4 to 7 years, with early complications reported for 582 operations.
Methods
Design
Single‑center case series
Operations November 1962 to December 1965
Patients
379 primary hip replacements followed ≥ 4 years
582 operations analyzed for early complications
Osteoarthritis in 70%
Rheumatoid arthritis in most of the rest
Treatment
Low‑friction total hip replacement
22 mm metal femoral head
High‑density polyethylene socket
Socket cemented (210) or press‑fit (169)
Follow-up
4 to 7 years
Outcomes
Pain and walking rated on a 1 to 6 scale
Range of movement
Mechanical failure
Infection
Key Findings
Mean final rating was 5.9 on the 1 to 6 scale for both pain relief and walking, with 90% graded excellent (Grade 6) and 10% good (Grade 5).
Only 2 of 210 cemented sockets loosened (1%), vs 11 mechanical failures among 169 press‑fit sockets (6.5%).
No femoral component loosened in any of the 582 hips.
Infection occurred in 3.8% of 582 hips (22), with 9 recognized in hospital and 13 (2.2%) appearing months or years later.
The author judged that the late infection findings tended to exonerate cement as a cause.
Range of movement improved in every hip but depended heavily on the preoperative range, and about 1 in 4 of the stiffest hips regained 90° of flexion.
Board pearl
In 7 sockets retrieved at post‑mortem, polyethylene wear averaged 0.13 mm per year, ranging from none in 6.5 years to 0.7 mm in 3 years.
Authors' conclusion
Apart from failures due to infection, the rate of which in the era under review was 3·8 per cent, late failures from mechanical causes were unusual after total hip replacement by this technique.