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Results of the Anatomic Medullary Locking Total Hip Arthroplasty at a Minimum of Twenty YearsA Concise Follow-up of Previous Reports*
Philip J. BelmontJr., MD1; Cara C. Powers, MD2; Sarah E. Beykirch, BS2; Robert H. HopperJr., PhD2; C. Anderson EnghJr., MD2; Charles A. Engh, MD2
1 Orthopaedic Surgery and Rehabilitation Service, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920-5001
2 Anderson Orthopaedic Research Institute, P.O. Box 7088, Alexandria, VA 22307. E-mail address for C.C. Powers: cpowers@aori.org
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Original Publications
Engh CA, McGovern TF, Engh CA Jr, Macalino GE. Clinical experience with the anatomic medullary locking (AML) prosthesis for total hip replacement. In: Morrey BF, editor. Biological, material, and mechanical considerations of joint replacement. New York: Raven Press; 1993. p 167-84.
Engh CA Jr, Culpepper WJ 2nd, Engh CA. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am. 1997;79:177-84.
Engh CA Jr, Claus AM, Hopper RH Jr, Engh CA. Long-term results using the anatomic medullary locking hip prosthesis. Clin Orthop Relat Res. 2001;393:137-46.
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Inova Health System and by a cooperative agreement that was awarded and administered by the United States Army Medical Research and Materiel Command (USAMRMC), and the Telemedicine and Advanced Technology Research Center (TATRC), under contract number W81XWH-05-2-0079. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (DePuy, Johnson and Johnson). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at Anderson Orthopaedic Research Institute, Alexandria, Virginia

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2008 Jul 01;90(7):1524-1530. doi: 10.2106/JBJS.G.01142
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Abstract: Between October 1982 and December 1984, the senior author performed 223 total hip arthroplasties in 215 patients with use of the anatomic medullary locking hip stem and TriSpike cup. We now report on 119 of these hips at a mean of 22.0 years (range, 20.0 to 25.0 years) after surgery. Of the fifty-six hips with minimum twenty-year follow-up radiographs and the original acetabular component, seventeen (30.4%) had pelvic osteolytic lesions measuring larger than 1.5 cm2. Of the sixty-eight hips with twenty-year radiographs and the original anatomic medullary locking stem, twenty-five (36.8%) had femoral osteolytic lesions measuring larger than 1.5 cm2. Acetabular osteolysis was significantly associated with cup loosening (p = 0.006), but the presence of femoral osteolysis was not associated with stem loosening. Kaplan-Meier analysis, with revision for any reason as the end point, revealed that the survival rate at twenty years was 85.8% ± 5.2% for the acetabular shell and 97.8% ± 2.2% for the stem. The most common reoperation was polyethylene exchange because of wear or osteolysis.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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