title: Revision total hip arthroplasty in patients with avascular necrosis.
abstract: This retrospective study compared the results of revision total hip arthroplasty (THA) in patients with avascular necrosis to patients with osteoarthritis. Twenty-two revision THAs (34 components) in 19 patients with avascular necrosis were compared with 35 revision THAs (55 components) in 31 patients with osteoarthritis. All of the procedures were performed by a single surgeon between 1981 and 1994, and all patients had a minimum of 2 years of follow-up. At the time of revision surgery, the average age was 54 years for the avascular necrosis patients and 67 years for the osteoarthritis patients (P=.002). Clinical and radiographic follow-up was performed for an average of 7 years (range: 2-12 years). Six (18%) components in the avascular necrosis group and nine (16%) components in the osteoarthritis group required re-revision for aseptic loosening an average of 7 years after the original revision (range: 2-11 years). Statistical analysis demonstrated no significant difference between the two groups in regard to the incidence of failure, time to failure, Harris Hip Score, and radiographic appearance. Contrary to expectations derived from the literature on primary THA, no difference was found between the outcome and survivorship of revision THA in patients with avascular necrosis and patients with osteoarthritis, despite a significant difference in age.
authors.affiliation: Department of Orthopedic Surgery, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
authors.forename: S Y
authors.initials: SY
authors.lastname: Wei
authors.forename: J J
authors.initials: JJ
authors.lastname: Klimkiewicz
authors.forename: M
authors.initials: M
authors.lastname: Lai
authors.forename: J P
authors.initials: JP
authors.lastname: Garino
authors.forename: M E
authors.initials: ME
authors.lastname: Steinberg
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005271:Femur Head Necrosis / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome