A modification of Charnley low-friction arthroplasty. Representative ten-year follow-up results of the St. Georg prosthesis.

From the stimulus offered by John Charnley in 1962, Hans Wilhelm Buchholz developed the St. Georg hip implant in Hamburg. The design differed from that of Charnley notably in the size of the femoral head. The results of early operations performed in Hamburg are confined largely to the most cogent form of failure, mechanical loosening of one or both components. Four representative years (1968-1971) were selected for this purpose, and survival curves were constructed for 1971 patients of different age and preoperative diagnosis. In conventional terms, the rate of mechanical loosening for the femoral component is 1.9%, for the acetabular component 2.4%, and for both components 7.5% for a ten or more year follow-up period. The principle annunciated by Charnley suggesting that total joint arthroplasty be performed in large units or special hospitals is strongly recommended.