LONG-TERM RESULTS OF ASEPTIC CEMENTED CHARNLEY REVISIONS

One hundred eighty low-friction arthroplasties of the hip in 164 patie nts in first-time revision surgery were operated between 1973 and 1985 . This series used only cement fixation, and aseptic loosening and fem oral stem fractures were the only indications for revision. The averag e follow-up period was 11.5 years. Intra-operative and postoperative c omplications were frequent: femoral shaft fracture (13 cases), femoral shaft perforation (12 cases), deep infection (14 cases), and dislocat ion (15 cases). Twenty-eight hips were rerevised or removed (resulting ina total cumulative probability of rerevision of 20% after 16 years, according to survivorship analysis). Nineteen cups were rerevised (13 % after 16 years, according to survivor ship analysis), and 24 femoral stems were rerevised (16% after 16 years, according to survivorship a nalysis). Radiographic cup and femoral loosening appeared in 29 and 36 cases, respectively (24 and 22% after 16 years, respectively, accordi ng to survivorship analysis). Good results were observed when there wa s a healthy and intact bone bed, whereas poor results were related to inadequate bone stock in the acetabulum and femur. Radiolucent lines w ere frequent in both components; radiolucent lines less than 2 mm wide were frequent in acetabular zone 1. Pistoning of the pros thesis and the cement within the bone and calcar pivot was the mast frequent type of stem loosening.