Clinical Orthopaedics and Related Research

, Volume 467, Issue 1, pp 166–173 | Cite as

Why Revision Total Hip Arthroplasty Fails

  • Bryan D. SpringerEmail author
  • Thomas K. Fehring
  • William L. Griffin
  • Susan M. Odum
  • John L. Masonis
Symposium: Papers Presented at the Hip Society Meetings 2008


Current outcomes data on revision total hip arthroplasty focuses on specific implants and techniques rather than more general outcomes. We therefore examined a large consecutive series of failed THAs undergoing revision to determine if survivorship and modes of failure differ in comparison to the current data. We retrospectively reviewed the medical records of 1100 revision THAs. The minimum followup was 2 years (mean, 6 years; range, 0–20.4 years). Eighty-seven percent of revision total hips required no further surgery; however, 141 hips (13%) underwent a second revision at a mean of 3.7 years (range, 0.025–15.9 years). Seventy percent (98 hips) had a second revision for a diagnosis different from that of their index revision, while 30% (43 hips) had a second revision for the same diagnosis. The most common reasons for failure were instability (49 of 141 hips, 35%), aseptic loosening (42 of 141 hips, 30%), osteolysis and/or wear (17 of 141 hips, 12%), infection (17 of 141 hips, 12%), miscellaneous (13 of 141 hips, 9%), and periprosthetic fracture (three of 141 hips, 2%). Survivorship for revision total hip arthroplasty using second revision as endpoint was 82% at 10 years. Aseptic loosening and instability accounted for 65% of these failures.

Level of Evidence: Level IV, therapeutic (retrospective) study. See the Guidelines for Authors for a complete description of levels of evidence.


Aseptic Loosening Revision Procedure Femoral Revision Radiographic Failure Index Revision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Anne Dennos, Amanda Phillips, and Caryn Thompson, CCRC, of the OrthoCarolina Research Institute for all of their hard work in collecting data for this project.


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Bryan D. Springer
    • 1
    Email author
  • Thomas K. Fehring
    • 1
  • William L. Griffin
    • 1
  • Susan M. Odum
    • 2
  • John L. Masonis
    • 1
  1. 1.OrthoCarolina, PACharlotteUSA
  2. 2.OrthoCarolina Research Institute, Inc.CharlotteUSA

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