Early failures in total hip arthroplasty -- a changing paradigm.
Between 2001 and 2011, 1168 revision hip arthroplasties were reviewed for "early" failures within 5 years of the primary total hip arthroplasty (THA). 24.1% underwent revision within 5 years of index THA. Aseptic loosening, infection, instability, metallosis, and fracture were common modes of failure. In our previous report from 1986 to 2000, 33% were "early" revisions, with instability and aseptic loosening accounting for over 70% of these early failures. While the proportion of "early" revisions decreased 9% from our previous report, this rate remains alarming. The emergence of metallosis and aseptic loosening of monoblock metal on metal shells as leading causes of early failures is concerning. This report suggests caution in the early adoption of new innovations before evidence based medicine is available to justify the risk of their use.
OrthoCarolina, Concord, North Carolina.
J Stuart
JS
Melvin
Lexington Clinic Orthopedics-Sports Medicine Center, Lexington, Kentucky.
Tharun
T
Karthikeyan
Ortho Carolina Research Institute, Inc., Charlotte, North Carolina.
Robert
R
Cope
OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.
Thomas K
TK
Fehring
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies
early failure; metallosis; revision; total hip arthroplasty; total hip replacement