title: Revision total hip arthroplasty: the influence of gender and age on the perioperative complication rate.
abstract: OBJECTIVE
  Aim of this study was to report the incidence of complications in a consecutive series of revision total hip arthroplasties (THA). Gender and age as a risk factor for the occurrence of perioperative complications in patients undergoing revision THA were analyzed specifically.
  
  
  METHODS
  All consecutive revision THA (n = 169) for aseptic loosening, which were performed between 1998 and 2002 were evaluated. Our study population had a mean age of 71.7 years and consisted of 65.7% women and 34.3% men. Complete exchange of the primary implant was performed in 49.7% (84/169). The cup was replaced in 66 cases (39.1%) the stem only in 11.2% of patients (19/169).
  
  
  METHODS
  Retrospective analysis was performed assessing the influence of gender and age on the complication rate by multiple regression models, estimating odds ratios (OR) and their 95% confidence intervals (CI).
  
  
  RESULTS
  Comparable complication rates to those reported in the literature were found. Overall incidence of complications was 29.6% with a fracture rate of 6.5%, dislocation rate of 8.3%, nerve palsy rate of 4.7% and occurrence of thromboembolism in 1.8% of the reported cases. Mortality rate during the observed period was low (0.6%). We were not able to provide statistical evidence for the impact of gender and age on the complication rate.
  
  
  CONCLUSIONS
  A comparable complication rate following revision THA to those reported in the literature was found in our study sample. Corresponding to other authors a higher risk of nerve palsy and thromboembolism among women was assessed. The observed correlation of fracture rates and female gender might be attributable to osteoporotic bone in postmenopausal women. Dislocation seemed to be more frequent in older patients, which has been described previously as well. Our low mortality rate in revision THA comparable to previous reports might be due to our short observation period.
  
  
  CONCLUSIONS
  Revision THA is associated with a higher risk of complications than primary THA. A predictive value of gender and age in regard to the overall complication rate could not be confirmed which should be considered while deciding about the therapeutic strategy confronted with an aseptically loosened THA. To provide statistical evidence of a correlation between gender, fracture and nerve palsy as well as age and dislocation rates greater study populations are required.
authors.affiliation: Orthopaedic Department (RKU), University of Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Kinkel
authors.forename: W
authors.initials: W
authors.lastname: Kaefer
authors.forename: W
authors.initials: W
authors.lastname: Reissig
authors.forename: W
authors.initials: W
authors.lastname: Puhl
authors.forename: S
authors.initials: S
authors.lastname: Kessler
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D011475:Prosthesis Failure; D012086:Reoperation; D012307:Risk Factors; D012737:Sex Factors