From the Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD.
J Am Acad Orthop Surg. 2021 Jan 15;29(2):78-87. doi: 10.5435/JAAOS-D-19-00860.
This study aimed to examine the major reasons for total hip arthroplasty (THA) failure and temporal patterns in THA revisions.
A retrospective chart review was conducted on 535 revisions performed on 444 THAs from January 2010 to May 2019 at our institution.
The average time to revision THA was 8.51 ± 8.38 years, with 136 cases (30.9%) occurring within 2 years after primary THA. The major mechanisms of failure that resulted in revision surgery were mechanical failure (162, 36.5%), metallosis (95, 21.4%), dislocation or instability (65, 14.6%), periprosthetic fracture (46, 10.4%), infection (44, 9.9%), hematoma or poor wound healing (15, 3.4%), and pain or other (17, 3.8%).
Based on our institutional experience over the past decade, mechanical failure without dislocation, metallosis, dislocation, periprosthetic fracture, and infection are typical reasons patients present for primary THA revision. Revisions within 2 years after primary THA are more likely to be the result of infection and periprosthetic fracture. Mechanical failure is the most common reason for revision THA overall, and mechanical failure and metallosis are more likely to be the reason revision is necessary 2 or more years after primary THA.
本研究旨在探讨全髋关节置换术（THA）失败的主要原因和 THA 翻修的时间模式。
对我院 2010 年 1 月至 2019 年 5 月期间进行的 444 例 THA 中的 535 例翻修手术进行回顾性图表分析。
翻修 THA 的平均时间为 8.51±8.38 年，其中 136 例（30.9%）在初次 THA 后 2 年内发生。导致翻修手术的主要失败机制是机械故障（162 例，36.5%）、金属中毒（95 例，21.4%）、脱位或不稳定（65 例，14.6%）、假体周围骨折（46 例，10.4%）、感染（44 例，9.9%）、血肿或愈合不良（15 例，3.4%）和疼痛或其他（17 例，3.8%）。
根据我们过去十年的机构经验，无脱位、金属中毒、脱位、假体周围骨折和感染的机械故障是患者初次 THA 翻修的典型原因。初次 THA 后 2 年内的翻修更可能是感染和假体周围骨折的结果。机械故障是翻修 THA 的最常见原因，而机械故障和金属中毒更可能是初次 THA 后 2 年或更长时间需要翻修的原因。
