Wagner resurfacing arthroplasty of the hip was performed on forty-one
hips in forty patients from 1977 to 1979. Results were analyzed with
particular attention to prosthetic failures, which occurred in fourteen
hips. Loosening of the femoral component occurred in five hips; loosening
of both the femoral and the acetabular component, in two hips; loosening of
the acetabular component, in two hips; loosening of the acetabular
component, in two hips; avascular necrosis of the femoral head (with no
concomitant femoral-component loosening), in two hips; and femoral neck
fracture, in three hips. Time to failure averaged eighteen months (range,
three months to two and one-half years). The over-all failure rate of 34
per cent is considered unacceptably high and therefore I do not recommend
the Wagner arthroplasty for routine use. Factors tht may be responsible for
the increased failure rate include a high susceptibility to avascular
necrosis of the femoral head, the younger age of patients in whom this
operation is performed, and the biomechanical design properties of the
prosthesis.