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Biomedical subjects

J Charnley

Publications and source records attributed to J Charnley.

75 records · Page 5Linked to original sources

Ectopic bone formation following low friction arthroplasty of the hip.

Ectopic bone formation after low friction arthroplasty (LFA) occurs nearly three times as often in males as in females and, in significant amounts, in 10 per cent of the total number of patients. The more limited the range of motion preoperatively, the more severe the degree of ectopic bone formation. The diagnosis does not closely relate to ectopic bone formation though the incidence is highest in osteoarthritis. The removal of osteophytes does not increase the incidence of ectopic bone formation. Trochanteric osteotomy in the surgical exposure is not an important cause of ectopic bone formation. A patient with ectopic bone after LFA on one side has a 92 per cent chance of developing it in a subsequent LFA on the opposite side. Systemic factors appear to play a dominant role in the production of ectopic bone.

Adult↗

Conversion of hip joint pseudarthrosis to total hip replacement.

Forth hips in 35 patients were converted from pseudarthrosis to low friction total hip arthroplasty (LFA). Pain, function and range of motion were improved in most cases. Gait was improved and number of walking aids required were reduced in most cases. Abduction against gravity and straight leg raising were also improved. Limb length was restored in all but 9 cases. Two cases dislocated postoperatively. One was reduced and did well; the other had a trochanter avulsion with recurrent subluxation. Improvement of function is a prime indication for converting a pseudarthrosis to LFA whereas pain is not so significant a factor. This is a formidable procedure requiring a complete range of prostheses and instruments and complete familiarity with the technique of total hip replacement but the end results are gratifying.

Adult↗

Radiological demarcation of cemented sockets in total hip replacement.

The frequency of radiological demarcation of the cement-bone junction in the acetabulum after total hip replacement has been examined in 141 Charnley low-friction arthroplasties followed for an average of 10.1 years. Sixty-nine per cent showed demarcation of various degrees and 9.2 per cent of the series showed evidence of progressive migration of the socket. The vast majority of cases with demarcation were symptomless. In most cases where demarcation was accompanied by migration the operation notes suggested a technical explanation and in three cases low-grade sepsis was responsible. The fact that nearly 30 per cent of cases showed no demarcation even after 10 years supports the idea that there is no fundamental defect in the principle of employing cement in the acetabulum. Better surgical technique may increase the number of cases showing no demarcation.

Acetabulum↗