Revision total hip arthroplasty: the patient's perspective

We evaluated a consecutive series of patients followed for at least 1 year after revision total hip arthroplasty. We surveyed 488 patients treated at three referral centers from 1998 to 2002. An experienced medical interviewer contacted patients and rated their degree of satisfaction with the original and revision arthroplasties, the reason of original arthroplasty failure, and their expectations for revision arthroplasty longevity. Surveys were completed on 320 of the 488 patients (66%). A member of the research team reviewed patients' operative reports, clinical records, and radiographs to determine the diagnosis at revision, procedure performed, and the most likely cause of failure. Patient satisfaction with the primary procedure was directly related to the time to revision. Most patients (214 of 320; 67%) expected their revision to last longer than their primary arthroplasty regardless of revision diagnosis or how long the primary procedure lasted before revision. The surgeons' failure assessments agreed with the patients' failure assessments only 36% of the time. Although the majority of patients (262 of 320; 82%) were satisfied with the results of the revision procedure, most did not agree with their surgeon as to why the original arthroplasty failed, and most had unrealistic expectations regarding revision longevity.