Survivorship of the Charnley Total Hip Arthrplasty in Juvenille Chronic Arthritis: A Follow-Up of 186 Cases for 22 Years

Abstract

Between 1971 and 1991 we performed Charnley low-friction arthroplasty (LFA) on 116 patients (186 hips) with juvenile chronic arthritis (JCA). We have now carried out a survival study, taking endpoints as revision, death or the end of the year 1993. Overall survival was 91.9% at ten years and 83.0% at 15 years. That of the femoral component was 95.6% at ten years and 91.9% at 15 years and of the acetabulum 95.0% and 87.8%, respectively. Only the use of steroids significantly impaired the survival. We therefore recommend the use of Charnley LFA for young patients with JCA requiring total hip replacement.

Survival of Bi-Metric femoral stems in 77 total hip arthroplasties for juvenile chronic arthritis

“…Our results-100% survival of the stem in terms of aseptic loosening during a mean follow-up period of 10 yearsare very good compared with other reports on this subject [5,6,8,12,16,18,22]. Among 1,047 THA for primary osteoarthritis, aseptic loosening of the Bi-Metric or Integral stem requiring revision surgery occurred in 6% [21].…”

“…Nevertheless, cemented fixation has also yielded good results in series of patients with JCA. Lehtimäki et al published a series of 186 cemented Charnley prostheses in JCA, reporting a combined survival rate of 92% for the prosthesis, 96% survival for the femoral component and 95% survival for the acetabular component at 10 years [16]. In a study of 17 THA (13 cemented and four cementless) in patients with JCA, five of the cemented hips were radiographically definitely loose with impending failure after a mean follow-up period of 9 years, whereas the four cementless ones were functioning well [18].…”

“…Patients are frequently young at the time of operation, and durability of arthroplasty is required for extended periods. Only a few series with a relatively small number of patients have been published [5,8,12,13,16,18].…”

Revision total hip arthroplasty in juvenile chronic arthritis: 17 revisions in 11 patients followed for 4–12 years

“…Although JCA patients are frequently lighter in weight and less active than those with osteoarthritis, initial prosthetic fixation is difficult because of abnormal anatomical development of the hip, small-proportioned more fragile bones with narrow medullary canals and thinner cortices, and limited sizes of implants (Scott et al 1984, Lachiewicz et al 1986, Witt et al 1991, Maric and Haynes 1993, Torchia et al 1996, Chmell et al 1997, Lehtimaki et al 1997, Haber and Goodman 1998, Kumar and Swann 1998. Revision surgeries in younger patients with chronic arthritis are even more complicated because of the additional loss of bone stock.…”

“…Total hip arthroplasty (THA) in juvenile chronic arthritis (JCA) provides significant relief of pain, and improved range of motion and function (Scott et al 1984, Lachiewicz et al 1986, Ruddlesdin et al 1986, Witt et al 1991, Maric and Haynes 1993, Torchia et al 1996, Chmell et al 1997, Lehtimaki et al 1997, Haber and Goodman 1998, Kumar and Swann 1998. The procedure is, however, complicated by the patient's young age, small stature, insufficient bone stock and abnormal bony anatomy, which are the result of a chronic inflammatory process during growth (Rahimtoola et al 2000).…”