Abstract
BackgroundTo clarify contemporary indications for first-time revision surgery after primary cementless total hip arthroplasty (THA) for addressing potential issues with cementless THA.MethodsData for 101 consecutive hips in 94 patients who underwent primary cementless THA at our institution and subsequently underwent first-time revision surgery were retrospectively reviewed. Baseline characteristics, indications for first-time revision surgery, and time from the primary THA to first-time revision surgery were evaluated.ResultsThe overall mean time to first-time revision surgery was 10.3 years (range, 0–33 years). The indications for first-time revision surgery were polyethylene wear and osteolysis in 33 hips, aseptic loosening in 25 hips, infection in 17 hips, periprosthetic fracture in 13 hips, instability in 8 hips, and component failure (liner dissociation or stem fracture) in 5 hips. Thirty-seven hips (37%) had undergone first-time revision surgery within 5 years of primary THA, of which the most common indications were infection and periprosthetic fracture.ConclusionThe current results suggested that reducing the number of early failures seems to be essential form improving THA outcomes.
Highlights
To clarify contemporary indications for first-time revision surgery after primary cementless total hip arthroplasty (THA) for addressing potential issues with cementless THA
Differences in the following characteristics between hips with first-time revision surgery performed within 5 years of THA and first-time revision surgery performed more than 5 years after THA were compared using Fisher’s exact test: gender, age at the time of initial THA, previous hip surgery, and diagnosis of osteoarthritis
The proportion of males and patients aged over 50 years was significantly higher among hips with first-time revision surgery performed within 5 years of THA than those performed more than 5 years after THA (p=0.0027 and p=0.0165, respectively) (Table 1)
Summary
To clarify contemporary indications for first-time revision surgery after primary cementless total hip arthroplasty (THA) for addressing potential issues with cementless THA. Total hip arthroplasty (THA) is recognized as one of the most successful surgeries of the twentieth century [1]. The number of surgeries performed each year and degree of durability have been increasing [2,3,4]. Osteolysis and aseptic loosening due to bearing surface could. Failure requiring revision surgery is an important issue. In 2006, Dobzyniak et al reported that 39% of patients underwent revision surgery within 5 years of initial THA. Instability was the main indication, followed by aseptic loosening [7]. Most procedures were due to instability and deep infection [8]. Motomura et al Journal of Orthopaedic Surgery and Research (2021) 16:140
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