Long term outcomes of Charnley THA in patients under the age of 50: an editorial comment on recently published article by Warth et al.

Fifty three years have passed from 1962 when Sir John Charnley developed the procedure of total hip arthroplasty (THA) in UK (1). Since then the principles of total joint replacement remain very similar to those advocated by Charnley. Moreover, the Charnley low friction arthroplasty represents the most classical cemented arthroplasty that has been used and currently used in several orthopaedic centers with minor changes regarding the initial procedure and implant design and the only implant where long term outcomes exceeding 30 years have been reported. The published literature is dominated by a large amount of studies reporting on outcomes of Charnley THA (2-5). The vast majority of these studies report on outcomes not exceeding follow-up periods longer than 30 years and usually involve a wide range of ages among the included patients. Although THA was initially developed to treat end-stage arthritic conditions in older patients, the need for the procedure in younger, more active patients is increasing. However, despite the improvements in the design of the implants and the surgical techniques THA in younger patients has not showed comparable outcomes to those performed in older patients, rising from the increased biomechanical demand of patients under 50 due to the higher activity levels (2,6).