The McKee-Farrar hip arthroplasty. A long-term study

Abstract

Between 1965 and 1973 a total of 808 McKee-Farrar metal-on-metal cemented total hip arthroplasties were performed in the Norfolk and Norwich Hospital. Of these, 230 surviving arthroplasties have been reviewed at average follow-up of 13.9 years. There were good or excellent results in 49% of the arthroplasties as judged by the Harris hip score with 78% of these having little or no pain. A comprehensive radiographic analysis was undertaken and a survivorship study of 81% of the total number of prostheses is presented.

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

“…Orthopaedic bearing designs incorporating gamma-airsterilized polyethylene proved to be more robust and reliable than other early alternatives, including first-generation metal-on-metal of the 1960s [4,94,120] and ceramic-onceramic bearings of the 1970s [17]. Difficulty in controlling the tolerances of early metal-on-metal hips has been hypothesized to result in seizure of some metal bearings culminating in early loosening [72], whereas first-generation alumina components were prone to unacceptably high fracture rates [141].…”

Aseptic loosening, not only a question of wear: A review of different theories

“…The resulting bone loss will enlarge the interface and ease the flow of joint fluid, resulting in higher transportation capacity of the debris and gradual loosening of the implant. Harris et al 1976Willert 1977 PE-particle Howie et al 1988 Metal-particle August 1986 Micromotion Ryd and linder 1989 Stress shielding Engh and Bobyn 1988 High fluid pressure Linder 1994Aspenberg and Van der Viis 1998Endotoxin Ragab et al 1999 Individual variations Matthews et al 2000 Sealed interface Schmalzried et al 1992 Various theories during the years regarding aseptic loosening Support for the above theory concerning effective joint space comes from the authors' own study on cemented acetabular components retrieved at autopsy (Schmalzried et al 1992b). Autopsy studies are important, since the well-functioning implant can be studied when no secondary changes such as osteoporosis and osteolysis have appeared.…”

“…Metalto-metal implants have less wear than metal-topolyethylene implants, and earlier results have been optimistic regarding wear and long-term results. However, aseptic loosening still occurs (August et al 1986, Visuri 1987, Jantsch et al 1991, Jacobsson et al 1996, Schmalzried et al 1996. Metal-to-metal implants are highly durable against wear, and newer designs may give better long-term results than old ones (McKellop et al 1996, Willert et al 1996, Higuchi et al 1997.…”

Acetabular Cups in 60 mm Metal-on-Metal Bearings Subjected to Dynamic Edge-Loading with 70° Peak-Inclination in 10-Million Cycle Simulator Study

“…Pioneering THA designs of the 1960-1970 era incorporated metal-on-polyethylene (MPE) and metal-on-metal (MOM) bearings, the latter using mainly cobalt-chrome alloys (as-cast CoCr). History shows that the 1st generation MOM bearings encountered many failures, considered multifactorial due to limited knowledge in design, instrumentation, and bone-fixation concepts [1][2][3][4][5][6]. In some cases, adverse CoCr wear produced severe biological reactions around the hip joints [3,7].…”