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Cemented Hip Replacements in Patients Younger than 50 Years: 16–24 Year Results

Although specialist centres have recorded a 75% survivorship of hip arthroplasty after 20 years (1), results in general orthopaedic units are unreported. Thirty-four patients with 45 primary cemented total hip arthroplasties implanted by “first generation” cementing techniques were reviewed after a mean of 20 years, documenting revision, occupation, and function. Twenty of the 35 (57%) hips were revised after a mean of 12 (2 to 21) years and reviewed after a mean of 7.6 years. Three hips had been subsequently re-revised. Seven out of nine (78%) hip arthroplasties in males failed, compared with 13 of 26 (50%) in females. Eighty-five percent failed by aseptic loosening. Five of nine employed patients had retired or changed profession. The mean Harris Hip Score was 73% (unrevised), 75% (revised), and 64% (re-revised). These results justify continuing efforts to improve technique and prosthetic design. Over a quarter of our patients were lost to follow up despite repeated contact over the previous 18 years, which mirrors the world literature. To adequately assess modern designs and techniques, we must improve retrieval. A national database would assist this.