Clinical studies of second revision in total hip replacement

Eleven patients (12 hips) underwent the second revision of total hip replacement. The mean age at the second revision was 61 years (range: 31 to 79); 2 patients were men and 9 women. Loosening of components was the most common reason for the revision surgery. Supplemental ring or wire-mesh reinforcement was used for the revision of the acetabular that had poor bone stock. On the acetabular side, an allograft was used in 4 hips; on the femoral side, a long stem was used in 11 hips. The mean operative time was 298 minutes (range: 195 to 525), and the mean bleeding volume was 2278 ml (range: 810 to 4800) which was about twofold more than that of the primary operation. The mean length of follow up after the second revision was approximately 5 years. In the clinical results, the mean total Japan Orthopaedic Association score was 56 points before the second revision and it was 70 points during the follow-up period. Pain score was especially improved after the second revision. On final roentgenographic examination there was noted a clear zone in three acetabular components and five femoral components. As yet, we have not experienced any case requiring a third revision.