Wagner surface replacement arthroplasty of the hip. Analysis of fourteen failures in forty-one hips.

Wagner resurfacing arthroplasty of the hip was performed on forty-one hips in forty patients from 1977 to 1979. Results were analyzed with particular attention to prosthetic failures, which occurred in fourteen hips. Loosening of the femoral component occurred in five hips; loosening of both the femoral and the acetabular component, in two hips; loosening of the acetabular component, in two hips; loosening of the acetabular component, in two hips; avascular necrosis of the femoral head (with no concomitant femoral-component loosening), in two hips; and femoral neck fracture, in three hips. Time to failure averaged eighteen months (range, three months to two and one-half years). The over-all failure rate of 34 per cent is considered unacceptably high and therefore I do not recommend the Wagner arthroplasty for routine use. Factors tht may be responsible for the increased failure rate include a high susceptibility to avascular necrosis of the femoral head, the younger age of patients in whom this operation is performed, and the biomechanical design properties of the prosthesis.