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

  • Neil G. BurkeEmail author
  • John P. Gibbons
  • Adrian J. Cassar-Gheiti
  • Fionnuala M. Walsh
  • James P. Cashman
Original Article



To establish the mode of failure of primary total hip replacement in patients under 50 years old.


A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) 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.


Mode of failure Revision total hip replacement Total hip replacement 


Compliance with ethical standards

All procedures performed in studies involving human participant were in accordance with the ethical standards of the institutional and /or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Prior to undertaking the study, the local institutional review board was consulted. As it is a retrospective study, the decision was made that formal consent was not required.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryCappagh National Orthopaedic HospitalDublinIreland

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