LONG-TERM DURABILITY OF CEMENTED PRIMARY TOTAL HIP-ARTHROPLASTY

The results of all primary cemented total hip arthroplasties that were performed at UCLA Medical Center between 1974 and 1982 and had at lea st 1 year of follow-up evaluation were reviewed. Five hundred ninety-s even hips were implanted in 513 patients receiving a T28 (81%), a TR28 (16%), or a Charnley (3%) prosthesis (all from Zimmer, Warsaw, IN). T he overall 15-year survival of the implants was 82%, although age at s urgery was a strong predictor of implant failure (P < .001). The 15-ye ar aseptic revision estimate was 37% in those patients younger than 50 at implantation, 17% in those patients aged 50 to 60 at implant surge ry, and 4% in patients older than 60 at surgery. After adjustment for patient age, primary etiology was not significantly related to implant failure. Sepsis necessitated revision in 2.6% of the patients by 10 y ears. Lucencies throughout all three acetabular zones were noted in 45 % of patients with long-term follow-up evaluation; however, this ''rad iographic loosening'' was not a good indicator of impending clinical f ailure. (Only 49% of these components required revision in the ensuing 10 years following evidence of radiographic loosening.) The results f or the younger patients are markedly inferior to those for older patie nts. Excellent results obtained with earlier prosthetic designs and ce menting techniques make cemented hip arthroplasty a strong contender f or the method of choice in the older patient.