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Re-revision total hip arthroplasty: Epidemiology and factors associated with outcomes
1New York University, Langone Medical Center, Langone Orthopaedic Hospital, Department of Orthopaedic Surgery, 301 E 17th Street, New York, NY, 10003, USA.
Journal of Clinical Orthopaedics and Trauma
|February 1, 2020
Summary
Re-revision total hip arthroplasty (THA) is often due to acetabular loosening, instability, or infection. Instability is a recurrent issue, increasing re-revision failure risk and infection rates.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Epidemiological Studies
Background:
- The epidemiology of re-revision total hip arthroplasty (THA) requires further investigation.
- Understanding risk factors associated with re-revision THA is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the epidemiology of re-revision THA.
- To identify risk factors associated with re-revision THA failure.
Main Methods:
- Analysis of 288 revision THA cases between January 2012 and December 2013.
- Inclusion of patients with two or more prior revision THAs, excluding those with first revision for periprosthetic joint infection (PJI).
- Definition of failure as reoperation.
Main Results:
- 51 re-revision patients were analyzed, with common indications including acetabular component loosening (29%), PJI (25%), and instability (18%).
- Instability as a first-revision or re-revision indication significantly increased re-revision failure risk (RR=3.000, p<0.001 and RR=1.867, p=0.038, respectively).
- 1-year re-revision survival rate was 54%.
Conclusions:
- Acetabular component loosening, instability, and PJI are primary drivers for re-revision THA.
- Instability represents a recurring challenge, contributing to re-revision failures and higher infection rates.
- Improved understanding of re-revision indications and patient factors is essential for managing expectations in this complex patient group.
