Factors Affecting Aseptic Failure of Fixation after Primary Charnley Total Hip Arthroplasty. Multivariate Survival Analysis* by SENEKI KOBAYASHI, KUNIO

Factors Affecting Aseptic Failure of Fixation after Primary Charnley Total Hip Arthroplasty. Multivariate Survival

Analysis*

by SENEKI KOBAYASHI, KUNIO TAKAOKA, NAOTO SAITO, and KENJI HISA

J Bone Joint Surg AmVolume 79(11):1618-1627

November 1, 1997

©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1 Diagram showing the distribution of the femoral components according to the radiographic signs that were present at the latest follow-up examination. * = radiographic failure

of fixation.

SENEKI KOBAYASHI et al. J Bone Joint Surg Am 1997;79:1618-1627


Fig. 2 Graph showing survival curves for the 293 acetabular components, with radiographic failure of fixation (A) and revision (B) as the end points.



Fig. 3 Graph showing survival curves for the 293 femoral components, with radiographic failure of fixation (A) and revision (B) as the end points.



Fig. 4 Graph showing the radiographic survival of the acetabular components in relation to the so-called biological classification of the osteoarthrosis2.



Figs. 5-A, 5-B, and 5-C: Anteroposterior radiographs of the right hip of a woman who had a total hip arthroplasty because of hypertrophic osteoarthrosis when she was sixty-two years old.



Fig. 5-B: Radiograph made at the time of discharge, showing a non-flanged socket that was cemented after removal of eburnated bone from the acetabular roof.



Fig. 5-C: Twenty years postoperatively, the well fixed cemented socket has no demarcation.



Figs. 6-A, 6-B, and 6-C: Anteroposterior radiographs of the right hip of a woman who had a total hip arthroplasty because of atrophic osteoarthrosis when she was sixty-two years old.



Fig. 6-B: Radiograph made at the time of discharge, showing a flanged socket that was cemented after anchor holes were made in preserved eburnated bone.



Fig. 6-C: Thirteen years postoperatively, the socket has migrated despite very little wear of the polyethylene (average rate, 0.01 millimeter per year).



Fig. 7 Graph comparing the radiographic survival between the thirty-one sockets that had rapid wear of the polyethylene (R) and the 262 that did not have rapid wear (S).



Fig. 8 Graph comparing the radiographic survival of the femoral components according to the canal-flare index34 (CFI).



Fig. 9 Graph comparing the radiographic survival of the femoral components according to the average width of the canal (CW).



Figs. 10-A, 10-B, and 10-C: Anteroposterior radiographs of the left hip of a woman who had a total hip arthroplasty because of normotrophic osteoarthrosis when she was sixty-two years old.



Fig. 10-B: Radiograph made at the time of discharge.



Fig. 10-C: Eleven years postoperatively, there is failure of fixation of the femoral component.



Fig. 11 Graph comparing the rates of radiographic survival, with revision as the end point, between the thirty-one acetabular components that had rapid wear of the polyethylene (R) and

the 262 that did not have rapid wear (S).



Fig. 12 Graph comparing the rates of radiographic survival, with revision as the end point, for the femoral components according to the canal-flare index34 (CFI).



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Factors Affecting Aseptic Failure of Fixation after Primary Charnley Total Hip Arthroplasty. Multivariate Survival Analysis* by SENEKI KOBAYASHI, KUNIO