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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 4, 458-462.
doi: 10.1302/0301-620X.87B4.15917  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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The Elite Plus total hip arthroplasty

THE NEED FOR RADIOLOGICAL SURVEILLANCE

N. P. Walton, FRCS (Trauma & Orth), Specialist Registrar in Orthopaedics; C. Darrah, RGN, Clinical Research Co-ordinator; L. Shepstone, PhD, Statistician; S. T. Donell, MD, Honorary Reader; and H. Phillips, FRCS, Consultant Orthopaedic Surgeon

Institute of Orthopaedics, Norfolk & Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK.

Correspondence should be sent to Mr N. P. Walton; e-mail: neil{at}nwalton22.fsnet.co.uk

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.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General