Forty-five cemented total hip replacements in thirty-eight patients who
were less than fifty years old were followed with physical examinations and
radiographs for five to eleven years (average, 7.3 years) after surgery.
The average age of the patients at the time of surgery was 40.7 years. The
average Iowa hip rating at follow-up was 91.9 points (range, 58 to 100
points). No surgical deaths, infections, or dislocations were encountered.
All of the patients had been repeatedly advised to avoid running, jumping,
heavy labor, and lifting more than forty pounds (eighteen kilograms).
Revision of a prosthetic component was necessary in four hips (8.9 per
cent); all of the revisions were successful. Radiolucent lines were seen
about the acetabular components of thirty-one hips but in only three (6.6
per cent) were these judged to be progressive bone-cement demarcation
lines. Only one of those three hips was symptomatic. Three hips (6.6 per
cent) also had subsidence of the femoral component into the femoral canal,
but only one hip was symptomatic. Resorption of the medial aspect of the
proximal end of the femur was seen in five hips, the maximum resorption
being three to five millimeters. I have concluded that cemented total hip
arthroplasty can give acceptable results in patients who are thirty to
fifty years old, and that the result can be reasonably long-lasting if the
patients are willing to avoid strenuous activity.