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What Are the Causes for Failures of Primary Hip Arthroplasties in France?

  • Symposium: 2012 International Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®



There are no large database cohorts describing the causes for failure of primary THAs in France. Because implants and causes for revision vary between national registers, it is important to obtain data from all countries.


We therefore determined (1) the mechanisms of failure of primary THAs, (2) their order of appearance with time, (3) the types of surgical techniques and implant designs used to perform revision THAs, and (4) 90-day complications after revision THA in France.


We prospectively collected data on all 2107 first-time revision THAs from 30 tertiary centers from January 1, 2010, to December 31, 2011. A dual-mobility liner had been used in 251 hips. Mean time from primary procedure to revision THA was 11.2 years (range, 1 day to 42 years). Mean age at revision was 70 years (range, 17–104 years).


The causes for revision were mechanical loosening (42%), periprosthetic fracture (12%), infection (11%), wear/osteolysis (11%), dislocation (10%), surgical technique error (6%), and implant fracture (3%). The most common type of revision procedure was all-component revision (49%). A dual-mobility liner was used in 1184 hips (62%). The 90-day dislocation rate was less than 4%, and mortality rate was 1.6%.


Contrary to other reported data, we found dislocation was not the main cause for failure of primary THAs but was still the more frequent early complication after revision. These findings might be related to the use of dual-mobility sockets in more than 10% of primary THAs and more than 60% of revision THAs.

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Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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  1. Australian Orthopaedic Association. National Joint Replacement Report 2011. Available at: Accessed October 25, 2012.

  2. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128–133.

    Article  PubMed  Google Scholar 

  3. Charnley J. Low Friction Arthroplasty of the Hip: Theory and Practice. New York, NY: Springer; 1979.

    Book  Google Scholar 

  4. Delaunay C, Epinette JA, Dawson J, Murray D, Jolles BM. Cross cultural adaptations of the Oxford-12 Hip Score to the French speaking population. Orthop Traumatol Surg Res. 2009;95:89–99.

    Article  PubMed  CAS  Google Scholar 

  5. Dripps RD. New classification of physical status. Anesthesiology. 1963;24:111.

    Google Scholar 

  6. Furnes O, Lie SA, Espehaug B, Vollset SE, Engesaeter LB, Havelin LI. Hip disease and the prognosis of total hip replacements: a review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987–99. J Bone Joint Surg Br. 2001;83:579–586.

    Article  PubMed  CAS  Google Scholar 

  7. Guyen O, Pibarot V, Vaz G, Chevillotte C, Caret JP, Bejui-Hugues J. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation. J Arthroplasty. 2007;22:849–858.

    Article  PubMed  Google Scholar 

  8. Hamadouche M, Arnould H, Bouxin B. Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res. 2012;470:3048–3053.

    Article  PubMed  Google Scholar 

  9. Hamadouche M, Biau DH, Huten D, Musset T, Gaucher F. The use of a cemented dual mobility socket to treat recurrent dislocation. Clin Orthop Relat Res. 2010;468:3248–3254.

    Article  PubMed  Google Scholar 

  10. [Health Authority. Evaluation of total hip prostheses: generic descriptions revising the list of reimbursable products and services of hip joint implants] [in French]. September 2007. Available at: Accessed November 25, 2012.

  11. Langlais F, Ropars M, Gaucher F, Musset T, Chaix O. Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res. 2008;466:389–395.

    Article  PubMed  Google Scholar 

  12. Lecuire F, Benareau J, Rubini J, Basso M. [Intra-prosthetic dislocation of the Bousquet dual mobility socket] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2004;90:249–255.

    Article  PubMed  CAS  Google Scholar 

  13. Lucht U. The Danish Hip Arthroplasty Register. Acta Orthop Scand. 2000;71:433–439.

    Article  PubMed  CAS  Google Scholar 

  14. Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am. 2002;84(suppl 2):2–20.

    PubMed  Google Scholar 

  15. Merle d’Aubigné R. [Numerical classification of the function of the hip. 1970] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1990;76:371–374.

    Google Scholar 

  16. Mertl P, Philippot R, Rosset P, Migaud H, Tabutin J, Van de Velde D. Distal locking stem for revision femoral loosening and peri-prosthetic fractures. Int Orthop. 2011;35:275–282.

    Article  PubMed  Google Scholar 

  17. National Joint Registry for England and Wales. 9th Annual Report 2012. Available at: Accessed January 27, 2013.

  18. New Zealand Orthopaedic Association. The New Zealand Joint Registry: thirteen year report. Available at: Accessed January 27, 2013.

  19. Philippot R, Adam P, Reckhaus M, Delangle F, Verdot FX, Curvale G, Farizon F. Prevention of dislocation in total hip revision surgery using a dual mobility design. Orthop Traumatol Surg Res. 2009;95:407–413.

    Article  PubMed  CAS  Google Scholar 

  20. Philippot R, Boyer B, Farizon F. Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res. 2013;471:965–970.

    Article  PubMed  Google Scholar 

  21. Swedish Hip Arthroplasty Register. Annual Report 2010. Available at: Accessed March 8, 2012.

  22. Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668 cases. Int Orthop. 2011;35:225–230.

    Article  PubMed  Google Scholar 

  23. Wetters NG, Murray TG, Moric M, Sporer SM, Paprosky WG, Della Valle CJ. Risk factors for dislocation after revision total hip arthroplasty. Clin Orthop Relat Res. 2013;471:410–416.

    Article  PubMed  Google Scholar 

  24. Wolf BR, Lu X, Li Y, Callaghan JJ, Cram P. Adverse outcomes in hip arthroplasty: long-term trends. J Bone Joint Surg Am. 2012;94:e103.

    Article  PubMed  Google Scholar 

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We thank all the orthopaedic surgeons from the 30 institutions who participated in this project (The SoFCOT Group): CHU d’Amiens, Hôpital Nord (Amiens, France): Jean-François Lardanchet, Patrice Mertl, Jérome Taviaux; Institut Calot (Berck, France): Alain Cazenave; CHU de Caen (Caen, France): Christophe Hulet, Benoit Lebel; CH de Cannes (Cannes, France): Jacques Tabutin; Hôpitaux Civils de Colmar (Colmar, France): Claude Schwartz; Hôpital St-Jacques (Clermond-Ferrand, France): Stéphane Boisgard, Stéphane Descamps, Myriam Galvin, Jean-Paul Levai; CHRU de Grenoble (Grenoble, France): Marc Blaysat, Dominique Saragaglia; CHU Roger Salengro (Lille, France): Henri Migaud, Grégory Kern; Department of Biostatistics, CERIM, Université Lille (Lille, France): Nassima Ramdane-Sebbane; Hôpital E Herriot–Pavillon T (Lyon, France): Jacques Bejui-Hugues, Jean-Paul Carret, Olivier Guyen; Centre Hospitalier Lyon Sud (Lyon, France): Romain Desmarchelier, Michel Fessy, Anthony Viste; Centre ostéo-articulaire des Cèdres (Echirolles, France): Jean-Louis Prudhon, François Steffann; CH Sainte Marguerite (Marseille, France): Jean-Noël Argenson, Xavier Flecher; SINCAL-CHU (Nancy, France): Daniel Molé, Richard Philippe, Olivier Roche; Hôtel Dieu (Nantes, France): Alexandre Bocéno, François Gouin, Norbert Passutti; Groupement cliniques privées GOS (Nice, France): Loys Descamps; Clinique Jouvenet (Paris, France): Fabrice Gaudot, Jean-Baptiste Leymarie, Thierry Siguier, Grégory Sorriaux; Hôpital Cochin–Pavillon Ollier (Paris, France): Jean-Pierre Courpied, Matthieu Karoubi; Institut Mutualiste Montsouris (Paris, France): Emmanuel de Thomasson; Hôpital Bichat (Paris, France): Philippe Loriaut, Philippe Massin; Hôpital Lariboisière (Paris, France): Laurent Sedel, Frédéric Zadegan; CHU Jean Bernard (Poitiers, France): Louis-Etienne Gayet, Simon Teyssédou; CH de Pont-Labbé (Pont-Labbé, France): François Gaucher; CHP St Grégoire (Rennes, France): Philippe Triclot; CHU Sud (Rennes, France): Denis Huten, Jean-Christophe Lambotte, Jean-Louis Polard; Clinique Chirurgicale Orthopédique (Rouen, France): Franck Dujardin; CHU de Saint Etienne (Saint Etienne, France): Bertrand Boyer, Frédéric Farizon; Centre de Chirurgie Orthopédique et Traumatologique de Strasbourg (Strasbourg, France): Jean-Yves Jenny; CHU Hautepierre (Strasbourg, France): François Bonnomet, Matthieu Ehlinger, Frédéric Leiber-Wackenheim, Jean-François Kempf; CHU Rangueil (Toulouse, France): Philippe Chiron, Nicolas Reina; and Hôpital du Chesnay (Versailles, France): Philippe Beaufils, Philippe Oger.

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Correspondence to Christian Delaunay MD.

Additional information

The institution of one or more of the authors (AD) has received, during the study period, funding from Société Française de Chirurgie Orthopédique et Traumatologique (SoFCOT, Paris, France).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

This work was performed at 30 French orthopaedic tertiary centers (see Acknowledgments).

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Delaunay, C., Hamadouche, M., Girard, J. et al. What Are the Causes for Failures of Primary Hip Arthroplasties in France?. Clin Orthop Relat Res 471, 3863–3869 (2013).

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