One-component revision in total hip arthroplasty: the fate of the retained component

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• One-component total hip arthroplasty (THA) is a common procedure.
• Assessing the long-term viability of retained components during THA revision is crucial for patient outcomes.
• Previous studies have not fully elucidated the fate of unrevised components in THA revision surgery.

Purpose of the Study:

• To evaluate the long-term outcomes of unrevised acetabular and femoral components following one-component THA revision.
• To determine if factors like component longevity or radiographic appearance warrant revision of stable, unrevised parts.

Main Methods:

• Retrospective analysis of 46 hips from 44 patients undergoing one-component THA revision.
• Inclusion of patients with a mean age of 58 years at the time of index operation.
• Long-term follow-up to assess subsequent revisions of unrevised acetabular and femoral components.

Main Results:

• Twenty-one percent (4/19) of unrevised acetabular components were later revised at a mean of 14 years post-index operation.
• Twenty-two percent (6/27) of unrevised femoral components were revised at a mean of 11 years post-index operation.
• Subsequent revisions occurred at mean times of 22 and 24 years from the primary operation for acetabular and femoral components, respectively.

Conclusions:

• Revision of a stable, unrevised component in one-component THA is generally not justifiable.
• Long duration of use or non-ideal positioning alone are insufficient reasons for component revision.
• Radiographic evidence of possible loosening in stable components should not automatically lead to revision surgery.