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Why revision total hip arthroplasty fails
Bryan D Springer1, Thomas K Fehring, William L Griffin
1OrthoCarolina, PA, Charlotte, NC 28207, USA. Bryan.Springer@orthocarolina.com
Clinical Orthopaedics and Related Research
|November 1, 2008
Summary
Revision total hip arthroplasty (THA) outcomes show instability and aseptic loosening are key failure modes. Survivorship at 10 years is 82%, with many needing further revision for different reasons.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Outcomes
- Biomaterials and Wear
Background:
- Current revision total hip arthroplasty (THA) research often focuses on specific implants.
- General outcomes and failure modes in revision THA require further investigation.
- Understanding revision THA failure patterns is crucial for improving long-term implant survival.
Purpose of the Study:
- To analyze survivorship and failure modes in a large series of revision total hip arthroplasties.
- To compare observed failure patterns with existing literature on revision THA.
- To identify common reasons for subsequent revision surgeries after initial THA revision.
Main Methods:
- Retrospective review of 1100 revision total hip arthroplasty cases.
- Minimum follow-up of 2 years, with a mean follow-up of 6 years.
- Analysis of reasons for subsequent revision surgeries and overall survivorship.
Main Results:
- 13% of revision THAs required a second revision surgery.
- The most frequent causes for revision were instability (35%) and aseptic loosening (30%).
- Ten-year survivorship for revision THA was 82%, with instability and aseptic loosening comprising 65% of failures.
Conclusions:
- Instability and aseptic loosening are the predominant modes of failure in revision total hip arthroplasty.
- A significant proportion of revision THAs necessitate further surgical intervention.
- These findings highlight areas for improvement in implant design and surgical techniques for revision THA.
