Review of total hip replacement. The Middlemore Hospital experience, 1980-1991

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Clinical Outcomes Research

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint dysfunction.
• Assessing long-term outcomes and complication rates is crucial for improving THA efficacy.
• Evaluating outcomes from a large cohort provides valuable insights into surgical performance.

Purpose of the Study:

• To determine the clinical outcomes of 1951 total hip arthroplasties.
• To assess complication rates including infection and dislocation.
• To identify predictors of revision surgery in THA.

Main Methods:

• Retrospective review of 1951 total hip arthroplasties performed between 1980 and 1991.
• Minimum two-year follow-up data obtained for 96.8% of cases.
• Survival analysis of commonly used implants and analysis of outcome predictors.

Main Results:

• Overall wound infection rate was 3.4%, with a revision rate for infection of 1.16%.
• In-hospital dislocation rate was 2.6%, requiring revision in 9.8% of cases.
• Revision rate for all causes was 8.7%, primarily due to loosening; patient satisfaction was acceptable. Spectron and Charnley implant survival rates at seven years were comparable to other studies.

Conclusions:

• Total hip arthroplasty outcomes were comparable to published series regarding patient satisfaction and revision rates.
• The wound infection rate was higher than ideal, potentially linked to the number of surgeons and lack of specialized facilities.
• Youth and patient weight were identified as significant predictors influencing revision rates.