The purpose of this study was to examine the ability of a surgeon to predict survival of a total hip replacement (THR) based on the patient’s diagnosis, demographics, postoperative activity level and the surgical technique.
Methods:
4 experienced hip surgeons were asked to predict the longevity of 131 Charnley THRs, performed by the senior author (GH) 22–35 years ago, by providing them with pre- and postoperative radiographs, and data concerning patient’s diagnosis, demographics, postoperative activity level and the surgical technique. This process was repeated 3 months later.
Results:
There was only a slight agreement between the majority of the predictions and actual outcome. The inter-observer agreement was also slight and intra-observer agreement ranged from slight to moderate.
Conclusion:
We confirmed that surgeons are unable to determine the life expectancy of the implants of a THR, based on the aforementioned data, because there are other non-identified factors that affect the survivorship of a THR. For this reason, regular follow-up remains the safest way to evaluate patients’ clinical picture and the evolution of radiographic changes, if there are any, in order to accurately advise patients and decide on the appropriate time for revision.
LearmonthIDYoungCRorabeckC.The operation of the century: total hip replacement. Lancet2007; 370: 1508–1519.
2.
HartofilakidisGBabisGCLampropoulou-AdamidouK.Total hip replacement: indications and preoperative assessment. In: HartofilakidisGBabisGCLampropoulou-AdamidouK. (eds) Congenital hip disease in adults. Italy: Springer, 2014; pp.53–61.
3.
WrightEAKatzJNBaronJA, et al. Risk factors for revision of primary total hip replacement: results from a national case-control study. Arthritis Care Res (Hoboken)2012; 64: 1879–1885.
4.
ProkopetzJJLosinaEBlissRL, et al. Risk factors for revision of primary total hip arthroplasty: a systematic review. BMC Musculoskelet Disord2012; 13: 251.
5.
JohnsenSPSørensenHTLuchtU, et al. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms. A nationwide Danish follow-up study including 36,984 patients. J Bone Joint Surg Br2006; 88: 1303–1308.
6.
BerryDJHarmsenWSCabanelaME, et al. Twenty-five-year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg Am2002; 84: 171–177.
7.
Lampropoulou-AdamidouKGeorgiadesGVlamisJ, et al. Charnley low-friction arthroplasty in patients 35 years of age or younger. Results at a minimum of 23 years. Bone Joint J2013; 95-B: 1052–1056.
8.
HartofilakidisGBabisGCLampropoulou-AdamidouK, et al. Results of total hip arthroplasty differ in subtypes of high dislocation. Clin Orthop Relat Res2013; 471: 2972–2979.
9.
HartofilakidisGCLampropoulou-AdamidouKIStathopoulosIP, et al. The outcome of 241 Charnley total hip arthroplasties performed by one surgeon 30 to 40 years ago. J Arthroplasty2015; 30: 1767–1771.
10.
HartofilakidisGStamosKIoannidisTT.Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg Br1988; 70: 182–186.
11.
HartofilakidisGStamosKKarachaliosT, et al. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am1996; 78: 683–692.
12.
GustiloRBBurnhamWH. Long-term results of total hip artrhoplasty in youngpatients. In: NelsonJP (ed.) The Hip Proceedings of the tenth open scientific meeting of the Hip Society. St Louis: CV Mosby Co, 1982, pp.27–33.
13.
SarmientoAEbramzadehEGoganWJ, et al. Cup containment and orientation in cemented total hip arthroplasties. J Bone Joint Surg Br1990; 72: 996–1002.
14.
HartofilakidisGBabisGCGeorgiadesG, et al. Trochanteric osteotomy in total hip replacement for congenital hip disease. J Bone Joint Surg Br2011; 93: 601–607.
15.
BarrackRLMulroyRDJrHarrisWH.Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review. J Bone Joint Surg Br1992; 74: 385–389.
16.
DorrLDTakeiGKConatyJP.Total hip arthroplasties in patients less than forty-five years old. J Bone Joint Surg Am1983; 65: 474–479.
17.
FleissJL.Statistical methods for rates and proportions. 2nd ed.New York: John Wiley & Sons, 1981, p.218.
18.
LandisJRKochGG.The measurement of observer agreement for categorical data. Biometrics1977; 33: 159–174.
19.
AncelinDReinaNCavaignacE, et al. Total hip arthroplasty survival in femoral head avascular necrosis versus primary hip osteoarthritis: case-control study with a mean 10-year follow-up after anatomical cementless metal-on-metal 28-mm replacement. Orthop Traumatol Surg Res2016; 102: 1029–1034.
20.
WroblewskiBMPurbachBSineyPD, et al. Charnley low-friction arthroplasty in teenage patients: the ultimate challenge. J Bone Joint Surg Br2010; 92: 486–488.
21.
AbdelMPRothPVHarmsenWS, et al. What is the lifetime risk of revision for patients undergoing total hip arthroplasty? A 40-year observational study of patients treated with the Charnley cemented total hip arthroplasty. Bone Joint J2016; 98-B: 1436–1440.
22.
SchmalzriedTPShepherdEFDoreyFJ, et al. The John Charnley Award. Wear is a function of use, not time. Clin Orthop Relat Res2000; 381: 36–46.
23.
JunnilaMLaaksonenIEskelinenA, et al. Implant survival of the most common cemented total hip devices from the Nordic Arthroplasty Register Association database. Acta Orthop2016; 87: 546–553.
24.
KarachaliosTHartofilakidisGZacharakisN, et al. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res1993; 296: 140–147.
25.
JohnstonRCBrandRACrowninshieldRD.Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am1979; 61: 639–652.
26.
HodgeWAAndriacchiTPGalanteJO.A relationship between stem orientation and function following total hip arthroplasty. J Arthroplasty1991; 6: 229–235.
27.
EstokDM2ndOrrTEHarrisWH.Factors affecting cement strains near the tip of a cemented femoral component. J Arthroplasty1997; 12: 40–48.
28.
KroellABeauléPKrismerM, et al. Aseptic stem loosening in primary THA: migration analysis of cemented and cementless fixation. Int Orthop2009; 33: 1501–1505.
29.
TaylorMPrendergastPJ.Four decades of finite element analysis of orthopaedic devices: where are we now and what are the opportunities?J Biomech2015; 48: 767–778.
