This paper describes the McKee-Farrar total hip prosthesis, a metal-on-metal chrome-cobalt design with both components cemented into bone. It reports the technique, rationale, and outcomes of the first fifty consecutive cases done for arthritic hips in Norwich. It asks whether replacing both the femoral head and acetabulum with a cemented metal joint can reliably relieve pain and restore movement.
The core principle here still governs modern arthroplasty: an implant works only as long as both components stay rigidly fixed. McKee and Watson-Farrar show that loosening presents clinically as pain on weight bearing, often referred to the knee and thigh, before radiographs turn obvious. When you see that pattern in a hip replacement patient, suspect a loose component early and image serially.
The paper distinguishes mechanical erosion (from a loose, micromotioning cement mantle) from a biological reaction to the cement itself. That distinction shaped decades of debate about why cemented implants fail and why fixation quality matters more than the material.
This is a case series with short follow-up (four years) and no comparison group, so weight the 90% figure accordingly. But the concepts are durable: metal-on-metal bearings, cement as a mechanical interlock, the abductor-sparing antero-lateral approach, and the danger of a vertical cup.
Cup orientation remains a board favorite, and this is one of the early statements of why a too-open cup impinges and loosens.
This paper describes the McKee-Farrar total hip prosthesis, a metal-on-metal chrome-cobalt design with both components cemented into bone. It reports the technique, rationale, and outcomes of the first fifty consecutive cases done for arthritic hips in Norwich. It asks whether replacing both the femoral head and acetabulum with a cemented metal joint can reliably relieve pain and restore movement.
The core principle here still governs modern arthroplasty: an implant works only as long as both components stay rigidly fixed. McKee and Watson-Farrar show that loosening presents clinically as pain on weight bearing, often referred to the knee and thigh, before radiographs turn obvious. When you see that pattern in a hip replacement patient, suspect a loose component early and image serially.
The paper distinguishes mechanical erosion (from a loose, micromotioning cement mantle) from a biological reaction to the cement itself. That distinction shaped decades of debate about why cemented implants fail and why fixation quality matters more than the material.
This is a case series with short follow-up (four years) and no comparison group, so weight the 90% figure accordingly. But the concepts are durable: metal-on-metal bearings, cement as a mechanical interlock, the abductor-sparing antero-lateral approach, and the danger of a vertical cup.
Cup orientation remains a board favorite, and this is one of the early statements of why a too-open cup impinges and loosens.