International Orthopaedics

, Volume 38, Issue 1, pp 39–46 | Cite as

The incidence of implant fractures after total hip arthroplasty

  • Patrick SadoghiEmail author
  • Wolfram Pawelka
  • Michael C. Liebensteiner
  • Alexandra Williams
  • Andreas Leithner
  • Gerold Labek
Original Paper



Implant fractures after total hip arthroplasty (THA) are considered as rare in clinical practice. Nevertheless they are relevant complications for patients, physicians, and the public health system leading to high socioeconomic burdens. The aim of this study was to assess the incidence of fractures after THAs in a comparative analysis of clinical studies and worldwide arthroplasty register datasets.


We calculated the pooled incidence of revision operations after fractures of THAs in a comparison of clinical studies published in Medline-listed journals and annual reports of worldwide arthroplasty registers in a structured literature analysis based on a standardised methodology.


Included clinical studies (sample-based datasets) were mono-centre trials comprising a cumulative number of approximately 70,000 primary implantations whereas worldwide national arthroplasty register datasets referred to 733,000 primary implantations, i.e. approximately ten times as many as sample-based datasets. In general, sample-based datasets presented higher revision rates than register datasets with a maximum deviation of a 14.5 ratio for ceramic heads, respectively. The incidence of implant fractures in total hip arthroplasty in pooled worldwide arthroplasty register datasets is 304 fractures per 100,000 implants. In other words, one out of 323 patients has to undergo revision surgery due to an implant fracture after THA in their lifetime.


Implant fractures in total hip arthroplasty occur in a relevant number of patients. The authors believe that comprehensive arthroplasty register datasets allow more general evaluations and conclusions on that topic in contrast to clinical studies.


Total hip arthroplasty Fracture Incidence Register dataset 



This study was conducted in the course of an EU project and supported by a grant from the EU Commission’s Directorate General for Public Health and Consumer Protection (DG SANCO). No further financial support has been received from other stakeholders such as the industry. Apart from the general framework of the project task, the support on the part of a public health institution had no influence whatsoever on the results.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Patrick Sadoghi
    • 1
    Email author
  • Wolfram Pawelka
    • 2
  • Michael C. Liebensteiner
    • 2
  • Alexandra Williams
    • 2
  • Andreas Leithner
    • 1
  • Gerold Labek
    • 2
  1. 1.Department of Orthopaedic SurgeryMedical University of GrazGrazAustria
  2. 2.Department of Orthopaedic SurgeryMedical University of InnsbruckInnsbruckAustria

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