CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.

BM Wroblewski; PD Siney; PA Fleming; B Purbach

doi:10.1302/0301-620X.91BSUPP_III.0910404c

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CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.

BM Wroblewski
PD Siney
PA Fleming
B Purbach

CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.

Wroblewski B, Siney P, Fleming P, Purbach B. CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.. Orthop Procs. 2009;91-B(SUPP_III):404-404. doi:10.1302/0301-620X.91BSUPP_III.0910404c

Wroblewski, BM, et al. “CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS..” Orthopaedic Proceedings, vol. 91-B, no. SUPP_III, 2009, pp. 404-404., https://doi.org/10.1302/0301-620X.91BSUPP_III.0910404c

Wroblewski, B., Siney, P., Fleming, P., & Purbach, B. (2009). CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.. Orthopaedic Proceedings, 91-B(SUPP_III), 404-404. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910404c

Wroblewski, B., Siney, P., Fleming, P. and Purbach, B. (2009) “CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS..” Orthopaedic Proceedings, 91-B(SUPP_III), pp. 404-404. Available at: https://doi.org/10.1302/0301-620X.91BSUPP_III.0910404c

Wroblewski, BM, PD Siney, PA Fleming, and B Purbach. “CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS..” Orthopaedic Proceedings 91-B, no. SUPP_III (2009): 404-404. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910404c

Wroblewski B, Siney P, Fleming P, Purbach B. CHARNLEY LOW-FRICTIONAL TORQUE ARTHROPLASTY SURVIVORSHIP PATTERNS: FOLLOW-UP TO 38 YEARS.. Orthop Procs. 2009 Sep 1;91-B(SUPP_III):404-404. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910404c

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Abstract

Introduction. Presentation of results by survivorship analysis method offers uniformity of terminology and comparability of results, an essential aspect of scientific communication. The Swedish National Total Hip Arthroplasty Register (SNTHAR) has set the standards with revision as the failure endpoint.

We set out to examine the survivorship after primary Charnley low-frictional torque arthroplasty (LFA) with revision as the end point, but documenting all the operative findings.

Methods & Results. Between November 1962 and June 2005, 22,066 primary operations in 17409 patients had been carried out at the author’s hospital by over 330 surgeons. By June 2006, 1001 (4.5%) hips have been revised.

Survivorship with revision as the end point was: infection 95%, dislocation 98%, fractured stem 88.6%, loose stem 72.5%, loose cup 53,7%.

Infection and dislocation are early problems. With improved cementing techniques stem loosening does not become a problem until 11 years after the primary. Loosening and wear of the ultra high molecular weight polyethylene cup is a significant long-term problem.

Discussion. Since revision is an event interrupting a process, its timing will influence the survivorship analysis pattern and indications and detailed operative findings will become important issues. Since clinical results do not reflect the mechanical state of the arthroplasty to await symptoms would invariably mean that revisions are likely to be carried out late and as such the complexity of complications are likely to increase. Furthermore, if information gathered is of a single “indication for revision”, and not of the operative findings at revision, the information would be of limited value.

Our conclusion is that regular follow-up after hip replacement is essential. The frequency, judged from the revision patterns, would suggest that every two years would not be unreasonable. Recording of all operative findings at revision is essential.

Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.