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Incidence of Contralateral THA After Index THA for Osteoarthritis

  • Symposium: Papers Presented at the Annual Meetings of The Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Currently more than 200,000 THAs are performed annually in the United States. In patients with bilateral disease, the chance of subsequent contralateral THA reportedly ranges from 16% to 85%. Factors influencing contralateral THA are not completely understood.

Questions/Purposes

We therefore determined (1) the 10-year probability free of progression to contralateral THA after index THA, (2) whether demographics differed between those who did and did not ultimately undergo contralateral THA, and (3) whether initial clinical symptoms and/or degree of radiographic osteoarthritis affects progression.

Patients and Methods

We retrospectively identified 332 patients with minimum 24-month followup and primary osteoarthritis who underwent unilateral THA between 2001 and 2008. There were 150 men and 182 women with a mean age of 61 years (range, 27–93 years) and a mean BMI of 29.6 kg/m2 (range, 17.6–49.2 kg/m2). We reviewed clinical, radiographic, and demographic data at index THA and last followup and classified patients as low, indeterminate, or high risk of undergoing contralateral THA.

Results

Seventy-four of the 332 patients (22%) underwent contralateral THA, resulting in an 83% 10-year probability free of progression to the contralateral hip. Low-risk patients had a less than 1% chance of progression, indeterminate-risk patients had a 16% to 24% chance of progression, and high-risk patients had a 97% chance of progression.

Conclusions

Indeterminate-risk patients may be managed nonoperatively and deserve further study with a larger multicenter analysis. We defined high- and low-risk patients who may be candidates for bilateral THA or may rarely need a contralateral THA.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, 21215, USA

    Siraj A. Sayeed MD, Aaron J. Johnson MD, David E. Jaffe MD & Michael A. Mont MD

Authors
  1. Siraj A. Sayeed MD
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  2. Aaron J. Johnson MD
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  3. David E. Jaffe MD
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  4. Michael A. Mont MD
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Corresponding author

Correspondence to Michael A. Mont MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. MAM has received royalties from Stryker Orthopaedics (Mahwah, NJ, USA); is a consultant for Johnson & Johnson (New Brunswick, NJ, USA), Joint Active Systems Inc (Effingham, IL, USA), Salient Surgical Technologies Inc (Portsmouth, NH, USA), Stryker, and TissueGene, Inc (Rockville, MD, USA); and has received institutional support from National Institutes of Health (NIAMS and NICHD), Stryker, TissueGene, and Wright Medical Technology, Inc (Arlington, TN, USA). The other authors have no disclosures.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Sayeed, S.A., Johnson, A.J., Jaffe, D.E. et al. Incidence of Contralateral THA After Index THA for Osteoarthritis. Clin Orthop Relat Res 470, 535–540 (2012). https://doi.org/10.1007/s11999-011-2110-9

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  • DOI: https://doi.org/10.1007/s11999-011-2110-9

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