Total hip arthroplasty: review of long-term results in 185 cases.

Review of 185 consecutive Muller total hip arthroplasties five to nine years after operation showed that 14 patients had died and that three deaths were directly related to the surgery. Of these, 37 patients (54 hips) could not be located and were excluded. Another patient, nonambulatory for an unrelated cause, was also excluded. A total of 126 hips in 104 patients were available for clinical and roentgenographic examinations with a minimal follow-up of five years. The final result was excellent in 70%, good in 10%, fair in 5%, and poor in 15%. One deep infection required removal of the prosthesis. There was no sciatic nerve injury. Five hips dislocated postoperatively and six others had recurrent subluxation. Replacement of the acetabular component was required in four hips, three because of loosening and the other for malposition in association with paraparesis. Trochanteric osteotomy was done in nine hips and four failed to unite. There was roentgenographic evidence of femoral component loosening in 28% of the hips and 8% required replacement. Poor cement filling and varus positioning of the femoral stem contributed to loosening.