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Risk factors for failure after cementless femoral revision THA: a consecutive series of 105 cases

  • Orthopaedic Surgery
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Abstract

Introduction

Cementless femoral revision total hip arthroplasty (RTHA) after periprosthetic fracture, aseptic loosening or infection is a challenging surgical procedure. The aim of this study was to evaluate the incidence and reasons for failure after two-stage septic revision, periprosthetic fracture or aseptic loosening that may reveal a rationale for cementless RTHA in two-stage revisions.

Materials and methods

A consecutive series of 105 cases using cementless femoral revision prostheses were evaluated retrospectively. Indications for revision were 39 two-stage revisions after infection, 49 aseptic loosenings, and 17 periprosthetic fractures. A Kaplan–Meier analysis was performed using infection with or without removal of the implant as an endpoint.

Results

Incidence of infection with or without implant removal was significantly higher in patients treated for periprosthetic fractures compared to two-stage revisions or aseptic loosening (log-rank P < 0.0001). The mean follow-up period was 6.4 (2.0–13.7) years. Using infection with or without implant removal as the endpoint, 12 patients were diagnosed after the index operation resulting in a cumulative risk after 13.7 years of 29.9% (95% CI 0–61.2).

Conclusion

Cementless revision using a modular tapered device is reliable with respect to reinfection risk in two-stage procedures.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author, [OEB], upon reasonable request.

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Acknowledgements

We thank T. Bruckner, Biometrics Consulting and Project Management, Heidelberg University for his support in statistical analysis.

Funding

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

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Authors and Affiliations

  1. Investigation Performed at BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, 67 071, Ludwigshafen, Germany

    O. E. Bischel

  2. Orthopaedic University Clinic, Klinikstr. 33, 35392, Giessen, Germany

    J. B. Seeger

  3. AUVA Trauma Center Salzburg, Dr. Franz-Rehrl-Platz 5, 5010, Salzburg, Austria

    A. J. Suda

Authors
  1. O. E. Bischel
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  2. J. B. Seeger
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  3. A. J. Suda
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Contributions

The following authors have (note only initials): O.E.B designed the study. (2) J.B.S, O.E.B. gathered the data. J.B.S., O.E.B. analysed the data. O.E.B., A.J.S. wrote the initial draft. J.B.S, A.J.S. ensured the accuracy of the data and analysis.

Corresponding author

Correspondence to A. J. Suda.

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All authors consent for publication.

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The institutional ethics committee approved this study.

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All procedures involving human participants were performed in accordance with the Declaration of Helsinki (1964) and its later amendments or comparable ethical standards.

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Bischel, O.E., Seeger, J.B. & Suda, A.J. Risk factors for failure after cementless femoral revision THA: a consecutive series of 105 cases. Arch Orthop Trauma Surg 142, 763–768 (2022). https://doi.org/10.1007/s00402-020-03723-w

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  • DOI: https://doi.org/10.1007/s00402-020-03723-w

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