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Multiple revisions for failed total hip arthroplasty not associated with infection
1Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
The Journal of Bone and Joint Surgery. American Volume
|October 1, 1987
Summary
Repeat hip revision surgery can improve pain and function for many patients, though some may still experience loosening or complications. Further revision may be necessary for persistent issues.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
- Revision THA is performed when the initial prosthesis fails.
- Infection-free failures necessitate repeat revision surgery.
Purpose of the Study:
- To evaluate the outcomes of repeat revision total hip arthroplasty.
- To assess pain, function, radiographic loosening, and complications after second and third revisions.
Main Methods:
- Retrospective review of 45 patients undergoing repeat revision THA (no infection).
- Follow-up for approximately 3 years, with no loss to follow-up.
- Assessment of pain, patient-reported improvement, and radiographic loosening (acetabular and femoral components).
Main Results:
- 28/45 patients reported no/slight pain after second revision; 30/45 improved.
- 6/7 patients reported no/slight pain after third revision; 5/7 improved.
- Radiographic loosening occurred in 8 acetabular and 13 femoral components after second revision; 3 acetabular and 1 femoral after third.
- Symptomatic loosening in 6 patients after second revision, 1 after third.
- 19/45 patients had significant postoperative complications.
- Treatment failure in 11 hips after second revision, 2 after third.
Conclusions:
- Repeat revision total hip arthroplasty can lead to pain relief and functional improvement.
- Radiographic and symptomatic loosening remain concerns after repeat revisions.
- Complications and treatment failures highlight the challenges of revision hip surgery.