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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 8, 1050-1054.
doi: 10.1302/0301-620X.87B8.16011  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Results of a hydroxyapatite-coated (Furlong) total hip replacement

A 13- TO 15-YEAR FOLLOW-UP

A. A. Shetty, MCh, FRCS, FRCS(Orth), Senior Fellow in Orthopaedics1; R. Slack, MRCS, FRCS(Orth), Specialist Registrar in Orthopaedics2; A. Tindall, MRCS, Specialist Registrar in Orthopaedics3; K. D. James, BSc, MBBS, Orthopaedic Senior House Officer4; and C. Rand, FRCS, FRCS(Orth), Consultant Orthopaedic Surgeon5

1 King’s College Hospital, Denmark Hill, London SE5 9RS, UK.
2 William Harvey Hospital, Ashford, Kent TN24 0LZ, UK.
3 Guy’s Hospital, St Thomas’ Street, London SE1 9RT, UK.
4 Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK.
5 Princess Royal University Hospital, Farnborough Common, Orpington, Kent BR6 8ND, UK.

Correspondence should be sent to Mr A. A. Shetty at 6 Barncroft Drive, Hempstead, Gillingham, Kent ME7 3TJ, UK; e-mail: mraashetty{at}yahoo.co.uk

We describe the survival of 134 consecutive JRI Furlong hydroxyapatite-coated uncemented total hip replacements. The mean follow-up was for 14.2 years (13 to 15).

Patients were assessed clinically, using the Merle d’Aubigné and Postel score. Radiographs were evaluated using Gruen zones for the stem and DeLee and Charnley zones for the cup. Signs of subsidence, radiolucent lines, endosteal bone formation (spot welds) and pedestal formation were used to assess fixation and stability of the stem according to Engh’s criteria. Cup angle, migration and radiolucency were used to assess loosening of the cup. The criteria for failure were revision, or impending revision because of pain or loosening. Survival analysis was performed using a life table and the Kaplan-Meier curve.

The mean total Merle d’Aubigné and Postel score was 7.4 pre-operatively and 15.9 at follow-up. During the study period 22 patients died and six were lost to follow-up. None of the cups was revised. One stem was revised for a periprosthetic fracture following a fall but none was revised for loosening, giving a 99% survival at 13 years. Our findings suggest that the long-term results of these hydroxyapatite-coated prostheses are more than satisfactory.




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