Clinical Analysis Of Revision Total Hip Arthroplasty In 19 Patients

Objective To study the cause and surgical procedure of revision of total hip arthroplasty(THA).Methods From January 2000 to January 2005, revision of total hip arthroplasty with extensively porous-coated femoral stem and cemented femoral stem was performed in 19 cases which included 7 males and 12 females, average age was 62.2 years (40~80 years). The reason for revision included aseptic loosening (twelve cases with 13 hips), acetabular wearing(three cases), septic loosening( two cases ), prosthetic breakage (one case), malposition of the acetabular component(one case). The mean time from initial repacement to revision is 10.2 years(1.5~15years). All cases were clinically evaluated using Harris hip score and radiography.Results All cases were followed up for average 25 monthes (13~57 monthes). The average preoperative Harris hip score was 38.8 points, which improved to 84.0points at one-year follow-up. The average Harris hip scoreimproved from 38.1 to 84.7 points with extensively porous-coated femoral stem and 39.4 to 83.2 points with cemented femoral stem respectively. Despite of one septic loosening in two years, no one is found loosening in radiography.Conclusions (1) The main reason of revision of THA is prosthetic aseptic loosening. In addition, acetabular wearing, septic loosening, prosthetic malposition and prosthetic breakage are also the usual factors. (2) Bone deficiency is the main problem in revision. Bone graft is an option according to different bone deficiency. (3) There is no difference in statistic result between porous-coated femoral stem and cemented one.