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Revision total hip arthroplasty.

B F Kavanagh, D M Ilstrup, R H Fitzgerald

    The Journal of Bone and Joint Surgery. American Volume
    |April 1, 1985
    PubMed
    Summary
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    Revision total hip arthroplasty improved patient function in 90% of cases. However, high rates of component loosening were observed, indicating potential long-term concerns for hip replacement outcomes.

    Area of Science:

    • Orthopedic Surgery
    • Biomedical Engineering
    • Radiology

    Background:

    • Total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
    • Revision THA is performed to address complications or failure of the primary implant.
    • Long-term outcomes and complication rates of revision THA require ongoing evaluation.

    Purpose of the Study:

    • To evaluate the clinical and radiographic outcomes of revision total hip arthroplasty performed for reasons other than infection.
    • To identify the incidence of complications and component loosening after revision THA.
    • To assess patient-reported outcomes and functional results using standardized scoring systems.

    Main Methods:

    • Retrospective review of 166 revision THA cases (162 patients) performed between 1969 and 1978.

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  • Clinical follow-up and radiographic analysis for a minimum of two years.
  • Assessment of outcomes using Modified Harris Hip Scores and a novel Mayo Clinic hip score incorporating radiographic data.

    • Main Results:

    • 90% of patients reported subjective improvement after revision surgery.
    • Radiographic analysis revealed probable loosening in 20.1% of acetabular and 44% of femoral components.
    • Symptomatic loosening occurred in 35 patients, leading to further revisions in some cases.
    • Good or excellent results were reported in 62% of hips based on Modified Harris Hip Scores and 52% using the Mayo Clinic hip score.

    Conclusions:

    • Revision total hip arthroplasty can lead to significant patient-reported functional improvement.
    • A high incidence of radiographic component loosening is a significant concern following revision THA.
    • Further research is needed to understand and mitigate the long-term risks of component loosening in revision hip surgery.