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Multiple Acetabular Revisions in THA - Poor Outcome Despite Maximum Effort.
O Bischel1, J B Seeger, Jb Seeger
1Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen-Marburg, UKGM, Klinikstrasse 33, D-35392 Giessen, Germany.
The Open Orthopaedics Journal
|November 30, 2012
Summary
Acetabular revision survival decreases with each prior surgery. Repeated acetabular component revisions show lower survival rates, highlighting the need for durable primary total hip arthroplasty (THA) and improved revision strategies.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- Acetabular revision surgery addresses failed hip replacements.
- Previous revisions negatively impact long-term implant survival.
- Reliable, non-extensively porous coated implants were used.
Purpose of the Study:
- To evaluate the survival rates of acetabular reconstructions in revision hip surgery.
- To determine the influence of the number of prior revisions on implant survival.
- To assess functional outcomes using the Merle d'Aubignée score.
Main Methods:
- Retrospective evaluation of 52 acetabular revisions.
- Inclusion criteria: at least one prior acetabular component exchange.
- Follow-up: mean 5.63 years (range 0.01-14.05 years).
Main Results:
- Cumulative survival at 14.05 years was 66.38% (aseptic loosening) and 58.42% (worst-case).
- Significantly lower survival for mechanical failure in patients with ≥2 previous revisions vs. 1 (p=0.0112).
- Mean Merle d'Aubignée score improved from 7.3 to 10.6.
Conclusions:
- Acetabular reconstruction survival decreases with an increasing number of prior revisions.
- This trend raises concerns given the rising need for revision THA.
- Improved primary THA durability, planning, and revision techniques/implants are crucial.
