Charnley Low-Frictional Torque Arthroplasty of the Hip

Part 1- General.- The concept of total hip arthroplasty: The beginning.- Arthroplasty of the hip -  A new operation – From low friction to low frictional torque.- Statements, comments and lessons from the past.- Ultra High Molecular Weight Polyethylene as the material for the cup.- Acrylic Cement.- A new surgical science.- Long-term follow-up – the “First 500”.- Clinical Results.- Clinical assessment.- The long-term results of low-friction arthroplasty of the hip performed as a primary intervention.- Radiographic assessment of the osteoarthritic hip.- Exposure of the Hip Joint.- Trochanteric osteotomy.- Instrument Tray System.- Post-operative length of hospital stay.- Part 2- Infection. – Deep Infection.- Deep infection: Establishing the incidence.- Deep Infection: Theatre Gowns.- Deep Infection: The role of Acrylic cement.- Antibiotic containing acrylic cement ACAC.- Leaching out from Acrylic cement.- Antibiotic containing cement spacers.- Patients at risk for deep infection.- Urethral instrumentation after LFA.- Late haematogenous infection.- Management of deep infection.- Part 3- Dislocation.- Dislocation.- Revision for recurrent or irreducible dislocation.- Revision for dislocation: Survivorship analysis.- Trocanteric Osteotomy and Dislocation.- Design of components, range of movement. impingement, dislocation.- Increasing the range of movements, putting off impingement.- Head size, range of movements, impingement, dislocation and cup loosening.- Part 4- Cup.- Bone-cement interface: The Cup - radiographic appearances.- Clinical results, radiographic appearances, histological findings.- The Charnley Acetabular cup.-  Part 5- Wear.- Wear of the UHMWPE cup.- Factors affecting wear of the UHMWPE cup.- Factors affecting wear: Patient activity level.-  Wear of UHMWPE Cup, endosteal cavitation and  component loosening.- Comparison of direct and radiographic wear measurements.- Penetration of UHMWPE cup,  Wear or creep.- Part 6- Stem.- Trochanteric osteotomy, trochanteric non-union and revision for dislocation.- Loosening of components.- Stem design and fixation.- Patterns of failure of stem fixation.- Leg over-lengthening after total hip arthroplasty. Identification of patients at risk.- Matt surface finish of the Charnley stem.- Dislocation and Fracture of the Stem.- Changes of stem design:  1968 – 1976.- Total hip arthroplasty: a foreign body bursa.- Total hip replacement – patterns of load transfer.- Position of the stem within the medullary canal.- Part 7- Clinical Results and Follow-up.- Radiographic appearances and clinical results.- The reasons for follow-up.- The reason for and the frequency of follow-up.- Patterns of failure and revisions: Guidelines for follow-up.- Changing patterns of patients presenting for the operation.