Total hip replacement-the cause of failure in patients under 50years old?

Abstract

To establish the mode of failure of primary total hip replacement in patients under 50years old. A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50years old. These were subdivided into early (< 5years) and late (> 5years) failures from the index procedure. The commonest mechanism of failure was aseptic loosening (42.3%) followed by metal-on-metal failure (15.8%), infection (14.4%) and instability (9.6%). The commonest cause of early revision surgery was due to metal-on-metal failure (27.8%) followed by aseptic loosening (19.7%) and infection (18.4%). In the late revision group, the main cause of failure was aseptic loosening (64%) and infection (10.7%). The changing trend of early revision due to metal-on-metal failure is important to recognise. Continuous review of the mechanism of primary total hip replacement failure is necessary to ensure the best patient outcome and maximise implant survivorship.