Changing indications for revision total hip arthroplasty

This was a retrospective review of two cohorts of 100 consecutive revisions performed 10 years apart by one surgeon, to determine the major reason for reoperation. For the early cohort, the indications for revision were: loosening of both components (38%), loosening of acetabular component (22%), loose hemiarthroplasty (13%), infection (10%), loosening of femoral component (8%), periprosthetic fracture (6%), recurrent dislocation (2%), and wear (1%). For the recent cohort, the indications for revision have significantly changed: loosening of acetabular component (24%), loosening of femoral component (22%) (p = .0048), recurrent dislocation (16%) (p = .0011), loosening of both components (15%) (p = .0002), wear-osteolysis (7%) (p = .03), infection (7%), loose hemiarthroplasty (6%), and periprosthetic fracture (3%). There has been a change in the indications for revision hip arthroplasty compared with 10 years ago, with a statistically significant increase in revisions for dislocation, wear-osteolysis, and loosening of the femoral component only.