Document Detail


Revision hip arthroplasty: infection is the most common cause of failure.
MedLine Citation:
PMID:  20195808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Revision total hip arthroplasty (THA), although relieving pain and restoring function, fails in some patients. In contrast to failures in primary THA, the frequency of the causes of failure in revision THA has been less well established.
QUESTIONS/PURPOSES: We therefore determined the rate of each failure mode and the survivorship of revision THAs.
METHODS: We retrospectively reviewed the charts of 1366 revision THAs performed between 2000 and 2007. There were 609 (44.5%) men and 757 (55.5%) women with a mean age of 66 years. The indications for the revision surgery were mainly aseptic loosening (51%), instability (15%), wear (14%), and infection (8%). The minimum followup was 1 day (mean, 5.5 years; range, 1 day to 9 years).
RESULTS: Two hundred fifty-six of the revisions (18.7%) failed with an average time to failure of 16.6 months (range, 1 day to 7.5 years). Among 256 failed hips, infection was the most common cause of failure (30.2%) followed by instability (25.1%) and aseptic loosening (19.4%). At 5 years, the survivorships of septic and aseptic groups were 67% and 84.8%, respectively. Revision for infection or instability appears to have a considerably lower survivorship when compared to revision for aseptic causes.
CONCLUSIONS: The lower survivorship of revision for infection or instability highlights the importance of implementing better preventative methods that can minimize the impact of these two major causes of failure.
LEVEL OF EVIDENCE: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
S Mehdi Jafari; Catelyn Coyle; S M Javad Mortazavi; Peter F Sharkey; Javad Parvizi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-07-20     Revised Date:  2011-08-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2046-51     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip*
Bacterial Infections / microbiology,  surgery*
Female
Hip Prosthesis / adverse effects*,  microbiology
Humans
Male
Middle Aged
Prosthesis Failure
Prosthesis-Related Infections / microbiology,  surgery*
Reoperation
Retrospective Studies
Surgical Wound Infection / microbiology,  surgery*
Treatment Failure
Young Adult
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