STEM FIXATION IN THE CHARNLEY LOW-FRICTION ARTHROPLASTY IN YOUNG-PATIENTS USING AN INTRAMEDULLARY BONE BLOCK

We report a prospective study of the use of intramedullary bone blocks to improve the fixation of a matt-finish femoral stem in Charnley low -friction arthroplasties, There were 379 patients (441 hips), but at a minimum follow-up of ten years there were 258 arthroplasties in 221 p atients including some which had been revised, The mean age at surgery was 41 years (17 to 51) and the mean follow-up was 13.4 years (1 to 2 0 including the early revisions), Nine stems (3.5%) had been revised f or aseptic loosening, but there were no stem fractures, Survivorship o f stems was 99.2% at ten years and 94.35% at 15 and 20 years, We found that the patient's gender, the position of the stem and the experienc e of the surgeon all influenced the outcome, Our findings suggest that using our method of stem fixation, follow-up of over 11 years was nee ded to reveal the effects of endosteal cavitation of the femur, and of over 13 years to assess any divergence between the clinical and the r adiological outcomes of stem fixation.