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The etiology of revision total hip arthroplasty: current trends in a retrospective survey of 3450 cases

  • Hip Arthroplasty
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

A Correction to this article was published on 23 September 2022

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Abstract

Introduction

Over the last years, the design of implants, the surgical approaches, and diagnostic tools changed in primary and revision of total hip arthroplasty. A knowledge of the different causes for revision after total hip arthroplasty is essential to avoid complications and failures. The purpose of this study was to determine trends of the etiology of implant failures over the last years by analyzing indications of revision hip arthroplasty.

Methods

All the patients who performed revision hip arthroplasties in our institution between 2001 and 2015 were reviewed retrospectively. Patient demographics, the indication for revision surgery as well as the procedure were assessed. Descriptive statistical analyses and association analyses were performed.

Results

Within our collective of 3450 revision hip arthroplasties, a total of 20 different indications were identified and categorized. Overall, 80.8% of the revisions were categorized as aseptic, 19.2% as septic implant failures. Some recently debated diagnoses like low-grade infection showed a high increase in incidence, whereas classic failure mechanisms like polyethylene wear showed a decrease over the time. In addition, the data revealed that cup loosening caused more revision surgeries than stem loosening.

Conclusion

This study successfully updated the current knowledge of different failure mechanisms in revision hip arthroplasties. The data proved that cup loosening was the most common failure mechanism in older patients, while in young patients, septic complications showed a high incidence. Probably, due to improved diagnostic tools, the percentage of infection in revision hip arthroplasty increased over the years.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany

    Jonas Kummerant, Nils Wirries, Alexander Derksen, Stefan Budde, Henning Windhagen & Thilo Floerkemeier

  2. BG Unfallklinik Frankfurt am Main gGmbH, 60389, Frankfurt am Main, Germany

    Jonas Kummerant

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Kummerant, J., Wirries, N., Derksen, A. et al. The etiology of revision total hip arthroplasty: current trends in a retrospective survey of 3450 cases. Arch Orthop Trauma Surg 140, 1265–1273 (2020). https://doi.org/10.1007/s00402-020-03514-3

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