The premature failure of the Charnley Elite-Plus stem - A confirmation of RSA predictions

被引:69
作者
Hauptfleisch, J [1 ]
Glyn-Jones, S [1 ]
Beard, DJ [1 ]
Gill, HS [1 ]
Murray, DW [1 ]
机构
[1] Univ Oxford, Nuffield Orthopaed Ctr, Botnar Res Ctr, Oxford Orthopaed Engn Ctr, Oxford OX3 7LD, England
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2006年 / 88B卷 / 02期
关键词
D O I
10.1302/0301-620X.88B2.17055
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
We performed a clinical and radiological study to determine the rate of failure of the Charnley Elite-Plus femoral component. Our aim was to confirm or refute the predictions of a previous roentgen stereophotogrammetric analysis study in which 20% of the Charnley Elite-Plus stems had shown rapid posterior head migration. It was predicted that this device would have a high early rate of failure. We examined 118 patients at a mean of nine years after hip replacement, including the 19 patients from the original roentgen stereophotogrammetric study. The number of revision procedures was recorded and clinical and radiological examinations were performed. The rate of survival of the femoral stems at ten years was 83% when revision alone was considered to be a failure. It decreased to 59% when a radiologically loose stem was also considered to be a failure. All the patients previously shown in the roentgen stereophotogrammetric study to have high posterior head migration went on to failure. There was a highly significant difference (p = 0.002) in posterior head migration measured at two years after operation between failed and non-failed femoral stems, but there was no significant difference in subsidence between these two groups. Our study has shown that the Charnley Elite-Plus femoral component has an unacceptably high rate of failure. It confirms that early evaluation of new components is important and that roentgen stereophotogrammetric is a good tool for this. Our findings have also shown that rapid posterior head migration is predictive of premature loosening and a better predictor than subsidence.
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页码:179 / 183
页数:5
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