Furlong hydroxyapatite hip arthroplasty in patients under the age of fifty
S Goodfellow, J Buchanan
Category: Furlong Clinical Results
Sunderland Royal Hospital
Early failure of hip arthroplasty in younger patients is notorious. Will Hydroxyapatite Ceramic Coated Hips (HAC) satisfy the demands of the younger patient and survive better? Method: Furlong HAC hips have been inserted since May, 1988. There are 234 hips in 197 patients aged fifty or less. Mean age is 42.2 years. Follow up is maximal at 17 years with 61 over ten years. Indications include osteoarthritis in 71 and rheumatoid arthritis in 17. Previous childhood hip disorders account for 44. There are 8 revisions from cemented hip replacement. Patients are assessed using the Harris Hip Score pre and post operatively. Post Mortem histology has been performed where appropriate. Results: There are 14 patients with Harris Hip Scores of less than 80 post operatively, but only 8 patients have problems attributable to HAC hip surgery. These include three with implant failure and three aseptically loosened components. There have been 5 deaths. No patients have thigh or groin pain. Post Mortem histology has shown early bony bonding to the HA ceramic coating. No debris disease has been seen in these hips. The failure rate of this sub group of 234 hips is 3.4% at a maximum follow up of 17 years. Conclusions: Hydroxyapatite bony bonding secures the implants. Aseptic loosening is minimal at 1.3%. Earlier surgery used polythene acetabular liners but alumina liners are now used obviating the risk of late debris disease. Newer alumina/zirconia ceramic material should reduce the incidence of ceramic failure. These early results are encouraging for use in the under fifties age group.
Data presented at BOA 2006, Glasgow, 27 – 29 September 2006.