Review of Total Hip Replacement. The Middlemore Hospital Experience, 1980-1991

Aim: To determine the outcome of 1951 total hip arthroplasties performed between 1980 and 1991 at Middlemore Hospital.

Methods: An independent retrospective review was carried out between 1993 to 1995 giving a minimum follow-up of two years. Useable data were obtained for 96.8% of cases.

Results: The overall wound infection rate was 3.4% (n=65), and of these seven (10.8%) required revision. The revision rate for infection for all patients was 1.16% (n=22). The in-hospital dislocation rate was 2.6% (n=49), and of these five (9.8%) required revision. Patient pain, activity and satisfaction were acceptable. Revision was required for 163 patients (8.7%), mainly for loosening. A survival analysis of the commonly used implants at seven years matched results from other studies. (Stem survival: Spectron 99.5%, Charnley 95.6%. Cup survival: Spectron 97.9%, Charnley 98.1%). Analysis of outcome predictors showed that youth and weight both influence the rate of revision.

Conclusions: Results in terms of patient satisfaction and revision rates were comparable with other published series. The wound infection rate was higher than desirable, but not unexpected in view of the number of surgeons involved (73) and the lack of special theatre facilities.