Good results with cemented total hip arthroplasty in patients between 40 and 50 years of age

Figures & data

Table 1.  Indications for primary total hip arthroplasty

Indications	No. of hips
Congenital hip dysplasia	39
Rheumatoid arthritis	24
Perthes' disease	5
Avascular necrosis eci	6
Epiphyseal dysplasia	2
Posttraumatic osteoarthritis	11
Bechterew's disease	1
Posttraumatic avascular necrosis	5
Synovitis villonodularis pigmentosa	1
Epiphysiolysis	6
Coxitis	3
Protrusio acetabuli	7
Osteomyelitis	2
Primary osteoarthrosis	17
TBC coxitis	3
Achondroplasia	1
Osteopetrosis	1
Alcohol-induced avascular necrosis	1
Corticosteroid-induced avascular necrosis	33
Kidney transplantation	14
Hodgkin's disease	6
Aplastic anemia	3
Non-Hodgkin lymphoma	2
Myelodysplastic syndrome	2
Henoch Schonlein disease	1
Eczema	1
Colitis ulcerosa	1
Chronic obstructive pulmonary disease	1
Pulmonary sarcoidosis	1
Vasculitis	1
Total	168

Table 2.  Reasons for revision and components revised

Reason for revision	THA	Cup	Stem	Total	Mean time (yr) to revision (range)
Aseptic loosening	9	5	1	15	10 (2.5–18)
Septic loosening	5	0	0	5	5.0 (0.9–13)
Recurrent dislocations	0	4	1	5	4.1 (0.3–11)
Fracture	0	0	2	2	8.5 (6.6–10)
Traumatic loosening	0	1	0	1	15
Neuropathy	0	1	0	1	2.4
Total	14	11	4	29	8.1 (0.3–18)

Figure 1.  A 43-year-old female with developmental dysplasia of the hips with high dislocation. A. Preoperatively. B. Directly postoperatively after primary THA with distalization and reconstruction of the cup to its anatomical center of rotation giving a neurological deficit. C. Postoperatively after cup revision 2 years later with cranialization of the cup. D. 12 years after cup revision.

Table 3.  Survival rates (95% CI) with all endpoints at 10 and 12.5 years

Component	Any reason		Any reason excl. infections		Aseptic loosening
	10 years	12.5 years	10 years	12.5 years	10 years	12.5 years
THA	88 (82–94)	80 (72–88)	91 (85–96)	83 (75–91)	94 (89–99)	89 (83–96)
Stem	92 (87–97)	88 (81–95)	95 (91–99)	91 (84–97)	97 (93–100)	94 (88–99)
Cup	90 (84–95)	84 (77–91)	92 (88–97)	86 (79–93)	94 (89–99)	91 (84–97)

Figure 2.  Kaplan-Meier survival curve with endpoint revision for aseptic loosening of any component (95% confidence intervals in broken lines).