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.
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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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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.
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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