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The long-term results of the Howse total hip arthroplasty. With particular reference to those requiring revision
Insights
The Howse hip arthroplasty shows acceptable outcomes for total hip replacement, especially for older patients and those with femoral neck fractures, with a 10-year revision rate of 8.3%.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Total hip arthroplasty (THA) is a common procedure for hip joint pathology.
- Assessing long-term outcomes of specific arthroplasty designs is crucial for clinical decision-making.
- The Howse hip arthroplasty is one such design requiring long-term evaluation.
Purpose of the Study:
- To evaluate the 10-year clinical outcomes of 506 consecutive Howse hip arthroplasties.
- To determine the revision rates and reasons for revision in this cohort.
- To assess the suitability of the Howse arthroplasty in specific patient populations.
Main Methods:
- Retrospective analysis of 506 consecutive Howse hip arthroplasty cases.
- Minimum follow-up period of 10 years.
- Data collection on mortality, early complications (dislocation, sepsis), and late revisions.
Main Results:
- 0.79% 30-day mortality.
- 1.38% early dislocation rate, with 2 revisions.
- 1.78% deep sepsis rate, with 8 revisions.
- Overall 10-year revision rate of 8.3% (42 hips).
- Common revision reasons: aseptic acetabular loosening (14 hips) and femoral stem fractures (11 hips).
Conclusions:
- The Howse hip arthroplasty demonstrates an acceptable dislocation rate and need for revision at 10 years.
- This implant may be a suitable option for older patients and those undergoing replacement for femoral neck fractures.
- Long-term performance indicates the Howse arthroplasty is a viable total hip replacement option.
Abstract:
We present the results of 506 consecutive Howse hip arthroplasties with a minimum follow-up of 10 years. The mortality within one month of surgery was 0.79%. The early dislocation rate was 1.38%, two hips requiring revision. Nine hips developed deep sepsis (1.78%), eight of which required revision. At 10 years 42 hips (8.3%) had required revision, including 14 with aseptic acetabular loosening and 11 with femoral stem fractures. We feel that as judged by the dislocation rate and the need for subsequent revision, the Howse arthroplasty is an acceptable form of total hip replacement, particularly in the older patient and in those requiring total replacement for femoral neck fractures.