{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:35:19Z","timestamp":1783481719194,"version":"3.55.0"},"reference-count":35,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"9","license":[{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:p>The original forged M\u00fcller straight stem (CoNiCr) has shown excellent ten- to 15-year results. We undertook a long-term survival analysis with special emphasis on radiological changes within a 20-year period of follow-up.<\/jats:p><jats:p>In all, 165 primary total hip replacements, undertaken between July 1984 and June 1987 were followed prospectively. Clinical follow-up included a standardised clinical examination, and radiological assessment was based on a standardised anteroposterior radiograph of the pelvis, which was studied for the presence of osteolysis, debonding and cortical atrophy.<\/jats:p><jats:p>Survival of the stem with revision for any reason was 81% (95% confidence interval (CI), 76 to 86) at 20 years and for aseptic loosening 87% (95% CI, 82 to 90). At the 20-year follow-up, 15 of the surviving 36 stems showed no radiological changes. Debonding (p = 0.005), osteolysis (p = 0.003) and linear polyethylene wear (p = 0.016) were associated with aseptic loosening, whereas cortical atrophy was not associated with failure (p = 0.008).<\/jats:p><jats:p>The 20-year results of the M\u00fcller straight stem are comparable to those of other successful cemented systems with similar follow-up. Radiological changes are frequently observed, but with a low incidence of progression, and rarely result in revision. Cortical atrophy appears to be an effect of ageing and not a sign of loosening of the femoral component.<\/jats:p>","DOI":"10.1302\/0301-620x.91b9.22023","type":"journal-article","created":{"date-parts":[[2009,8,31]],"date-time":"2009-08-31T21:42:45Z","timestamp":1251754965000},"page":"1158-1163","source":"Crossref","is-referenced-by-count":27,"title":["Fixation and loosening of the cemented M\u00fcller straight stem"],"prefix":"10.1302","volume":"91-B","author":[{"given":"M.","family":"Clauss","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Kantonsspital Liestal, Rheinstrasse 26, CH 4410, Liestal, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Luem","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kantonsspital Liestal, Rheinstrasse 26, CH 4410, Liestal, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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