[Replacement of total hip prosthesis--what does the patient expect? Analysis of 248 aseptic hip revisions]

Aseptic loosening of prosthesis with consequential revision operations continues to be a major problem for both the patients concerned and the medical team. In the center of interest stands the magnitude of bone destruction caused by loosening effects. A concept designed to avoid uncontrolled progressive loss of bone stock is presented. Based on the experience of 248 cases of hip revision operations, advice to patients can be given. 2 septic (0.8%) and 6 aseptic (2.4%) cases with loosening and re-revision were documented. Statistical analysis of 5-year survivorship rate according to Kaplan-Meier shows 94.5%, and according to Armitage 92.5%. Clinical and radiologic 5-10-year findings in the first 72 consecutive cases are presented. Routine controls in patients with hip prostheses for early detection of bone destruction may help to perform simple and prognostically favourable revision operations.