Long-term durability of cemented primary total hip arthroplasty.

The results of all primary cemented total hip arthroplasties that were performed at UCLA Medical Center between 1974 and 1982 and had at least 1 year of follow-up evaluation were reviewed. Five hundred ninety-seven hips were implanted in 513 patients receiving a T28 (81%), a TR28 (16%), or a Charnley (3%) prosthesis (all from Zimmer, Warsaw, IN). The overall 15-year survival of the implants was 82%, although age at surgery was a strong predictor of implant failure (P < .001). The 15-year aseptic revision estimate was 37% in those patients younger than 50 at implantation, 17% in those patients aged 50 to 60 at implant surgery, and 4% in patients older than 60 at surgery. After adjustment for patient age, primary etiology was not significantly related to implant failure. Sepsis necessitated revision in 2.6% of the patients by 10 years. Lucencies throughout all three acetabular zones were noted in 45% of patients with long-term follow-up evaluation; however, this "radiographic loosening" was not a good indicator of impending clinical failure. (Only 49% of these components required revision in the ensuing 10 years following evidence of radiographic loosening.) The results for the younger patients are markedly inferior to those for older patients. Excellent results obtained with earlier prosthetic designs and cementing techniques make cemented hip arthroplasty a strong contender for the method of choice in the older patient.