REVISION TOTAL HIP ARTHROPLASTY

Abstract

Introduction: In revision total hip surgery the surgeon can encounter problems much more difficult and the results definitely not as satisfactory as after a primary total hip arthroplasty(1). The main reason for failure is loss of bone stock, which leads to mechanical problems and instability, also, dislocation, deep sepsis and fracture of the femoral shaft(2). The aim of this study is to evaluate and analyse the causes of failure of total hip arthroplasty which require revision surgery and the proper planning for the revision procedure. Material and Methods:We reviewed a combined prospective and retrospective 20 patients who underwent revision hip arthroplasty in El-Sahel teaching hospital,during the period between Januray, 2008 and December 2012.The average age of the patients was54 years. There were 12 males and 8 females. . In this study the Harris hip score was used for clinical evaluation of the patients both preoperatively and postoperatively which had a score for pain, function, absence of deformity and range of motion out of a hundred point().Also,radiographic analyses was performed when follow up was made at 6 weeks, 12 weeks, 6 months, 1 yearand2 years. Results: Because of variation in general health, and tolerance for discomfort, the clinical picture and radiographic findings did not always coincide. The mean pre-revision harris hip score (3) was 34.18 points [minimum 1 point, maximum 69 points, SD 17.17], while, the mean hip score initial post revision was 80.82 points [minimum 43.00 points, maximum 97.00 points, SD 12.16]. The mean score difference was 46.64 points. The final overall evaluation results were (66%) of patients had excellent or good clinical results and (34%) of patients had either fair or poor clinical results. ( MEAN , ± SD ) Conclusion: The revision total hip arthroplasty is a complicated operation, expensive to perform, and does not give results as good as a primary joint replacement. Of all causes of failure of total hip arthroplasty perhaps careful evaluation and selection of each patients, definite indication and careful proper surgical technique are the most important aspects in preventing failure. Key wards: Revision, Total hip, Arthroplasty,Instability, Fracture.