Late complications and long-term outcomes following aseptic revision of a hip arthroplasty performed for oncological resection.
OBJECTIVE
In order to achieve an oncological margin during limb salvage surgery for tumours around the hip, part or the entire hip joint is frequently sacrificed. Hip arthroplasty restores a functional extremity and achieves limb salvage. Currently there is a paucity of data concerning the late complications, long-term survival, and the risks of re-revision following aseptic revision of a total hip arthroplasty (THA) performed following an oncological resection.


METHODS
We identified 78 patients who underwent aseptic revision of a THA which was performed for an oncological process involving the hip from 1972 to 2006. All patients had a minimum 5 years of follow-up with a mean of 13 years. Outcomes were compared to 1,378 patients undergoing aseptic revision of a THA that was performed for a diagnosis of osteoarthritis.


RESULTS
The mean 5-, 10-, 15-, and 20-year re-revision-free survival for an oncologic process of the hip was 100%, 85%, 69%, and 57%. Within this cohort, younger patients were at an increased risk of revision surgery. There was no difference in survivorship of the revision implant at any of the aforementioned time points between the oncologic and osteoarthritis cohorts. Patients with an oncologic diagnosis had a higher rate of dislocations, component wear, and loosening compared to the osteoarthritis group.


CONCLUSIONS
Late complications following revision surgery of THA performed for an oncologic resection are common. The results of this study provide information for counselling patients on implant survivorship and complications following aseptic revision THA after index surgery for an oncologic indication.
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Matthew T
MT
Houdek
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Eric R
ER
Wagner
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Benjamin K
BK
Wilke
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Cody C
CC
Wyles
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Michael J
MJ
Taunton
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota - USA.
Franklin H
FH
Sim
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D061214:Patient Safety; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome