title: Midterm Outcomes of Revision Total Hip Arthroplasty Using a Modular Revision Hip System.
abstract: BACKGROUND
  The growth in hip arthroplasty surgery has meant a corresponding escalating revision burden with increasing challenges for the orthopaedic surgeon. The purpose of this study was to review clinical outcomes of a modular revision hip system within a single institution.
  
  
  METHODS
  We retrospectively reviewed a cohort of modular revision hip system stems performed in our institution between January 2005 and October 2012 giving a potential minimum follow-up of 2 years. Clinical outcomes data on complications, Oxford Hip Score (OHS, 0-48) and patient satisfaction were collected. Radiographic outcomes including subsidence were assessed. Implant survival was estimated using Kaplan Meier analysis.
  
  
  RESULTS
  115 stems in 106 patients were identified. All cause survival was 82% (95%CIs: 73%-89%) at 6.1 years; survival excluding infection being 99% (95%CIs: 93%-100%). There was a low incidence of subsidence (seven stems) and no peri-prosthetic fractures. Primary cause of re-revision in this series was re-infection with only one re-revision for mechanical failure. Median Oxford Hip Score at mean follow up 4.1 years (2-9) was 40 (14-48) and 93% of patients reported being satisfied with their revision surgery.
  
  
  CONCLUSIONS
  This study showed good clinical outcomes and survival using a modular revision stem with low mechanical failure and subsidence. Recurrence of infection remains a challenge in revision surgery.
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, West Dunbartonshire, UK.
authors.forename: Marie Anne
authors.initials: MA
authors.lastname: Smith
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, West Dunbartonshire, UK.
authors.forename: Angela H
authors.initials: AH
authors.lastname: Deakin
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, West Dunbartonshire, UK.
authors.forename: David
authors.initials: D
authors.lastname: Allen
authors.affiliation: Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, West Dunbartonshire, UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Baines
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data; D005260:Female; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011474:Prosthesis Design; D012086:Reoperation / Q000295:instrumentation / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: failure; femoral stem; revision hip arthroplasty: modular; survival