Unsatisfactory results after repeated revision of hip arthroplasty

Abstract

61 cemented second revision total hip arthroplasties and 18 cemented third revision total hip arthroplasties were studied with emphasis on causes of failure, complications, risk of further revision, and clinical and radiographic results of surviving, not further revised patients. Aseptic loosening was the major reason for both second and third revisions followed by recurrent dislocations. Of 61 second revisions, 21 failed again. Postoperative dislocation was the major complication, encountered in 10/61 after second revisions and in 4/18 third revisions. 10 second revisions were reoperated on without exchange of components, but for causes related to the implant. The clinical and radiographic outcome of surviving, not further revised patients was favorable, but must be seen in the light of the high rate of further revisions. In 33 of 53 second revisions and in 5 of 13 third revisions left for evaluation, the outcome was considered unsatisfactory. We conclude that reoperations for failed arthroplasties should be the prerogative of highly experienced centers.