Long-term results of an individual surgeon.

In conclusion, my 17-year experience with total hip arthroplasty leads me to believe that hip replacements can be done in a standard operating room if adequate preoperative precautions are taken, traffic in the operating room is strictly controlled, and prophylactic antibiotics are given (infection rate 0.28 per cent). Cemented resurface arthroplasty was not a successful enough operation to warrant its continued use (revision rate 44 per cent). The revision rate for all hips operated on 10 or more years ago was 7.0 per cent. In patients younger than fifty years of age, a revision rate of 19.6 per cent was observed after 10 years. Excessive body weight and heavy physical activity levels were frequently noted among the failures. Total hip arthroplasty should be done cautiously in patients under 50 and very rarely in patients under 30. Thirteen of the 25 revisions required in the early series were due to stem fracture, a complication rarely seen now with improved stem design and superalloy metallurgy. Despite radiologic identification of prosthesis loosening, revision THR may not be necessary for many years, if at all. Uncemented arthroplasty, particularly the acetabular component, seems to hold promise for the future; however, the experience to date is too limited to make any definite conclusions.