This study concerns the fate of the first 100 Charnley total hip
replacements done in ninety ninety patients at The Hospital for Special
Surgery. At the time of this study, the follow-up of the surviving
sixty-seven patients ranged from nine and one-half to eleven and one-half
year (average, ten years). When studied at an average of ten years after
the initial operation, twenty-six of the original 100 hips that had been
operated on had been lost to follow-up due to death, and seven could not be
traced. Of the remaining sixty-seven hips that were available for clinical
evaluation, thirty-seven were rated as excellent; twenty-two, as good;
four, as fair; and four, as poor, according to The Hospital for Special
Surgery scoring system. The radiographs of fifty-four of the sixty-seven
hips were available for this evaluation. Twenty-three of these hips showed
radiographic signs of problems that appeared to have no significant bearing
on the quality of their clinical results. There was loosening of the
femoral component in five hips which occurred within the first three years
after operation and then apparently stabilized. One required reoperation
eight years after the original surgery. There was one fracture of the
femoral stem eight years after the original operation, requiring
reoperation. Six hips demonstrated so-called calcar resorption, the
greatest measuring fourteen and thirty millimeters. Ten acetabular
components showed wear of more than one millimeter, the maximum being five
millimeters in both components of a patient with bilateral hip replacement.
Two acetabular components migrated, one requiring reoperation due to
progressive bone loss nine and one-half years after the original procedure.
All three reoperations have been successful to date.