[Reoperation of hip endoprostheses]

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total hip replacement (THR) is a common procedure.
• Reoperations for THR are complex and require careful planning.
• Long-term outcomes of THR depend on managing complications like loosening and bone loss.

Purpose of the Study:

• To describe experiences with 106 reoperations following 1968 total and 18 Wagner arthroplasties.
• To establish guidelines for managing THR reoperations.
• To evaluate the necessity and timing of revision surgery.

Main Methods:

• Review of 106 reoperations in 88 patients between 1969 and 1991.
• Analysis of radiological findings and clinical symptoms.
• Consideration of patient age, acetabular, and femoral states in surgical planning.

Main Results:

• Yearly radiological examinations are recommended post-THR.
• Radiological signs alone in asymptomatic patients do not necessitate reoperation.
• Significant bone loss with loosening in asymptomatic patients requires reoperation due to fracture risk and compromised reimplantation.

Conclusions:

• Stable fixation is the primary goal in THR reoperations.
• Cementless prostheses and bone grafting are suggested for patients under 60 with significant bone loss.
• Reoperation for THR demands advanced surgical skills.