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Updated: Jan 31, 2026
Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
Total hip replacement-the cause of failure in patients under 50 years old?
Neil G Burke1, John P Gibbons2, Adrian J Cassar-Gheiti2
1Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Dublin, Ireland. nei1burke@yahoo.co.uk.
Aim:
To establish the mode of failure of primary total hip replacement in patients under 50 years old.
Methods:
A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) failures from the index procedure.
Results:
The commonest mechanism of failure was aseptic loosening (42.3%) followed by metal-on-metal failure (15.8%), infection (14.4%) and instability (9.6%). The commonest cause of early revision surgery was due to metal-on-metal failure (27.8%) followed by aseptic loosening (19.7%) and infection (18.4%). In the late revision group, the main cause of failure was aseptic loosening (64%) and infection (10.7%).
Conclusion:
The changing trend of early revision due to metal-on-metal failure is important to recognise. Continuous review of the mechanism of primary total hip replacement failure is necessary to ensure the best patient outcome and maximise implant survivorship.
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