One hundred consecutive Muller curved-stem total hip replacements were
reviewed ten years after operation. Twenty patients with twenty-two
arthroplasties had died within the ten-year period without having a
revision, and twenty-five arthroplasties had been revised for various
reasons. Of the remaining fifty-three arthroplasties, thirty-five were
classified as good or excellent, with Harris hip scores of 80 points or
higher, and eighteen were classified as poor or fair, with scores lower
than 80 points. Follow-up radiographs, made for all but six of the
fifty-three hips at ten years, showed a 23 per cent incidence of migration
of the acetabular component and a 28 per cent incidence of migration of the
femoral component. In addition, there was a 15 per cent incidence of bone
resorption in the proximal end of the femur without migration of the
femoral component and a 4 per cent incidence of osteolytic defects about
the femoral component, also without migration. Combining the
radiographically loose replacement (migration) with the clinically loose
ones (revised), the over-all incidence of aseptic loosening was 29 per cent
for the acetabular component and 40 per cent for the femoral component.
There was a positive correlation between the incidence of loosening of the
femoral component and younger age, heavier weight, male sex, unilateral hip
disease, a wide femoral canal, and varus position of the femoral component,
whereas the incidence of loosening of the acetabular component was
increased only in association with older age. The rate of loosening of the
femoral component appeared to be higher during the early follow-up period
and to decrease with time, while the rate of loosening of the acetabular
component appeared to be lower during the early follow-up period but to
increase with time.