Outcomes of Revision Total Hip Arthroplasty in Patients 60 Years and Younger
The annual volume of patients requiring revision total hip arthroplasty prior to age 60 is projected to increase considerably. Despite this, outcome data for revision THA in these younger patients remain limited. The purpose of this study was to define implant survivorship, identify risk factors for...
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| Published in: | The Iowa orthopaedic journal Vol. 43; no. 2; pp. 38 - 44 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
The University of Iowa
01-12-2023
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The annual volume of patients requiring revision total hip arthroplasty prior to age 60 is projected to increase considerably. Despite this, outcome data for revision THA in these younger patients remain limited. The purpose of this study was to define implant survivorship, identify risk factors for re-revision, and determine clinical outcomes of revision THA in patients aged ≤60 years.
We identified 191 revision THAs performed in patients aged ≤60 years. Minimum 4-year follow-up was obtained in 141 (73.8%) hips (mean 10.3 years [range, 4-20]). Mean age was 48 years (range, 20-60). Forty-five hips (32%) had previously been revised. Indications for index revision included aseptic loosening (28%), polyethylene wear (26%), dislocation (20%), and infection (14%). Outcome measures were Kaplan-Meier survival free from re-revision and patient-reported outcome scores (mHHS, UCLA).
Survivorship free from re-revision for any cause was 78% [95% CI=70-85] at five years and 71% [62-78] at ten years. The most common indication for re-revision at both five and ten years was dislocation (12% [8-19], 16% [10-23]), followed by infection (6% [3-12], 10% [5-18]) and aseptic loosening (2% [1-7], 4% [1-11]). Mean scores were improved from baseline at six (mHHS +21.4, UCLA +0.9) and twelve years (mHHS +13.4, UCLA +0.5).
Revision THA in patients less than 60 years of age was associated with considerably lower rates of early loosening-related failure than historically reported. Recurrent dislocation and infection appear to remain challenges in this population. Despite improvements in survivorship from earlier studies, patient-reported functional improvements remained relatively unchanged.
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Sources of Funding: This work was support by the Curing Hip Disease Fund (JCC), the Jacqueline & W. Randolph Baker Fund (JCC), … The Foundation for Barnes-Jewish Hospital (JCC, Award Reference 5228), and the Jackie & Randy Baker Research Fellowship Fund (JCC). Disclosures: No direct conflicts of interest related to the work however, a full list of conflicts of interest are listed: AAOS: board or committee member (CPH); American Association of Hip and Knee Surgeons: board or committee member (CPH), Stryker: research support (CPH); GlaxoSmithKline: stock or stock options (GEP); Department of Defense grant: research support (JCC); Hip Society: board of committee member (JCC); International Hip Society: board or committee member (JCC); International Society for Hip Arthroscopy: board or committee member (JCC); Microport: IP royalties (JCC); Microport Orthopedics, Inc: paid consultant (JCC); Wolters Kluwer Health-Lippincott Williams & Wilkins: publishing royalties, financial or material support (JCC); Zimmer: paid consultant, research support (JCC). |
| ISSN: | 1541-5457 1555-1377 |