This is Charnley's landmark 1972 report on 379 primary low-friction total hip arthroplasties performed from 1962-1965. It asks whether a cemented 22-mm metal head against high-density polyethylene delivers durable pain relief and mechanical stability over 4-7 years. This paper is the foundation of modern total hip replacement.
When Charnley began this work, hip arthroplasty was considered too unreliable for routine use — Teflon cups had caused catastrophic tissue reactions, and no one had proven that any implant could last beyond a few years.
This paper changed that. A 92.7% success rate with 1.3% mechanical failure in cemented constructs at 4-7 years gave surgeons the evidence base to offer THA as a definitive treatment for end-stage hip arthritis, not a last resort.
Two findings from this paper should live in your clinical memory. First, infection outpaced loosening as a failure mode. This is why we obsess over sterile field technique, prophylactic antibiotics, and antibiotic-laden cement. Second, late infection can present years after an apparently successful arthroplasty. When a patient returns with a rising ESR after THA, do not assume loosening without ruling out infection first.
The Merle d'Aubigné-Postel scale with Charnley's A/B/C prefix, introduced here, became the international template for THA outcome reporting and directly informed the Harris Hip Score and modern PROMs. You will see it on the OITE.
This is Charnley's landmark 1972 report on 379 primary low-friction total hip arthroplasties performed from 1962-1965. It asks whether a cemented 22-mm metal head against high-density polyethylene delivers durable pain relief and mechanical stability over 4-7 years. This paper is the foundation of modern total hip replacement.
When Charnley began this work, hip arthroplasty was considered too unreliable for routine use — Teflon cups had caused catastrophic tissue reactions, and no one had proven that any implant could last beyond a few years.
This paper changed that. A 92.7% success rate with 1.3% mechanical failure in cemented constructs at 4-7 years gave surgeons the evidence base to offer THA as a definitive treatment for end-stage hip arthritis, not a last resort.
Two findings from this paper should live in your clinical memory. First, infection outpaced loosening as a failure mode. This is why we obsess over sterile field technique, prophylactic antibiotics, and antibiotic-laden cement. Second, late infection can present years after an apparently successful arthroplasty. When a patient returns with a rising ESR after THA, do not assume loosening without ruling out infection first.
The Merle d'Aubigné-Postel scale with Charnley's A/B/C prefix, introduced here, became the international template for THA outcome reporting and directly informed the Harris Hip Score and modern PROMs. You will see it on the OITE.