The elite plus total hip arthroplasty : The need for radiological surveillance

• Published in: Journal of bone and joint surgery. British volume Vol. 87; no. 4; pp. 458 - 462
• Main Authors: WALTON, N. P, DARRAH, C, SHEPSTONE, L, DONELL, S. T, PHILLIPS, H
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.04.2005; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Age Factors; Aged; Arthroplasty, Replacement, Hip - methods; Biological and medical sciences; Cementation - methods; Epidemiologic Methods; Female; Hip Joint - diagnostic imaging; Hip Prosthesis; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Prosthesis Failure; Radiography; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Reoperation; Drug combination; Femur; Prognosis; Radiodiagnosis; Evaluation scale; Prosthesis; Exploration; Joint; Hip; Standards; Stem; Radiography; Need; Orthopedic surgery; Treatment; Surveillance; Loosening; Medium term; Age; Cup; International
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.87B4.15917

We prospectively studied 217 patients who underwent 234 Elite Plus total hip arthroplasties. At a mean of 6.4 (SD 0.7) years post-operatively, 39 patients had died and 22 were either lost to follow-up or had no radiographs available. Clinical (Oxford hip score) and radiological assessments were performed on 156 patients (168 hip arthroplasties) who had a mean age of 67.7 (SD 9.7) years at operation. In the assessed group, 26 of 159 (16.4%) of femoral stems which had not already been revised and 19 of 159 (11.9%) of acetabular cups were definitely loose. In total, 52 of 168 (31%) of hips had either been revised or had definite evidence of loosening of a component. We could not establish any relationship between clinical and radiological outcomes. Despite the fact that the clinical outcome and rate of revision for the Elite Plus appeared to meet international standards, our findings give us cause for concern. We believe that joint registries should include radiological surveillance in order to provide reliable information about medium-term outcomes for hip prostheses.