SHORT-TERM RESULTS OF TOTAL HIP REPLACEMENTS PERFORMED BY VISITING SURGEONS AT AN NHS TREATMENT CENTRE

144 total hip replacements were performed by Swedish Orthopaedic Surgeons at Weston NHS Treatment Centre between 2004–2006, in an attempt to reduce the waiting list in Cardiff. Following concerns regarding the outcome of knee arthroplasty patients, the Welsh Assembly funded a clinical and radiographic review of all hip arthroplasty patients from the same unit. 100 hips were reviewed at a mean follow-up of 24 months. The mean Oxford Hip Score was 30 (range 12–60). Radiolucencies were seen in acetabular zone 1 in 34, and all 3 zones in 28 hips. Femoral component position was >4 degrees varus in 41 cases. Medial floor breach with intrapelvic cement was seen in 12 cases. 10 cases had >1cm leg length discrepancy. There were 3 early dislocations, 1 intraoperative distal femoral fracture, 1 Pulmonary Embolus and 2 superficial infections. 4 patients have received further treatment so far, and 12 have been listed for acetabular component revision for loosening. 1 has been listed for stem revision for symptomatic leg length discrepancy of 2.5cm. There is an unacceptably high early failure rate in this group of patients. The cost of further investigation and revision surgery far outweighs cost-savings achieved by outsourcing treatment to a distant centre.