Thirty-year Results of a Prospective Study of Charnley Total Hip Arthroplasty by the Posterior Approach

We present the results of 228 consecutive Charnley low friction hip arthroplasties, performed in 193 patients, between July 1972 and December 1976. Unusually for this time, all hips were inserted by the posterior approach without a trochanteric osteotomy. All patients were enrolled into a prospective study; both preoperative and postoperative clinical and radiologic findings were recorded. This series was independently reviewed in 1985 (Atrah SGK. Long-term follow-up of Charnley total hip replacement through posterior approach. MSc thesis, University of London, 1987) and again in 2002. The preoperative and perioperative findings were similar to contemporary series. Implant positioning was also assessed. Because of our stable population, only 2 patients were lost to follow-up. Our survivorship results show a 10-year survival of 93% deteriorating to a 30-year survival of 73% (+/-6.1). The survivors were assessed radiologically and scored clinically using the Merle d'Aubigné-Postel score with a mean value of 12. The reason for revision was also recorded. These results are comparable to other studies and justify the use of the posterior approach.