Sobba Walter, Habibi Akram A, Shichman Ittai, Aggarwal Vinay K, Rozell Joshua C, Schwarzkopf Ran
Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
Department of Orthopedic Surgery, NYU Langone Health, New York, New York; Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv, Tel-Aviv, Israel.
J Arthroplasty. 2024 Mar;39(3):782-786. doi: 10.1016/j.arth.2023.09.011. Epub 2023 Sep 17.
Isolated acetabular component revision is an effective treatment for revision total hip arthroplasty patients who have well-fixed femoral implants. We aimed to evaluate the modes of acetabular failure following primary total hip arthroplasty and to identify factors associated with increased morbidities and postoperative outcomes.
We conducted a retrospective analysis and identified 318 isolated aseptic acetabular revisions. We separated patients by ≤90 days, 91 days to 2 years, and >2 years for acetabular revisions and compared demographics, reasons for revision, 90-day readmissions, rerevisions, and postrevision infections. Revisions ≤90 days, 91 days to 2 years, and >2 years accounted for 10.7, 19.2, and 70.1% of revisions, respectively. Revisions ≤90 days, 91 days to 2 years, and >2 years had their primary total hip arthroplasty at a mean age of 66, 63, and 55 years (P < .001), respectively.
Revisions within 90 days were mainly indicated for dislocation/instability (58.8%) or periprosthetic fracture (23.5%) while revisions over 2 years were indicated for polyethylene wear/osteolysis (37.2%). Patients with revisions past 90 days were more likely to require rerevision compared to patients with revisions within 90 days (P < .001). There were no differences in readmissions (P = .28) or infection rates (P = .37).
Acetabular revisions within 90 days were more commonly indicated for instability and periprosthetic fracture, while those over 2 years were indicated for polyethylene wear. Revisions past 90 days were more likely to require subsequent rerevisions without increased 90-day readmissions or infections.
Retrospective cohort study.
对于股骨假体固定良好的全髋关节置换翻修患者，单纯髋臼组件翻修是一种有效的治疗方法。我们旨在评估初次全髋关节置换术后髋臼失败的模式，并确定与发病率增加和术后结果相关的因素。
我们进行了一项回顾性分析，确定了318例单纯无菌性髋臼翻修病例。我们将髋臼翻修患者按≤90天、91天至2年和>2年进行分组，并比较了人口统计学特征、翻修原因、90天再入院情况、再次翻修情况和翻修后感染情况。≤90天、91天至2年和>2年的翻修分别占翻修病例的10.7%、19.2%和70.1%。≤90天、91天至2年和>2年的翻修患者初次全髋关节置换时的平均年龄分别为66岁、63岁和55岁（P<.001）。
90天内的翻修主要是因为脱位/不稳定（58.8%）或假体周围骨折（23.5%），而2年以上的翻修是因为聚乙烯磨损/骨溶解（37.2%）。与90天内翻修的患者相比，90天后翻修的患者更有可能需要再次翻修（P<.001）。再入院率（P=.28）或感染率（P=.37）没有差异。
90天内的髋臼翻修更常见的原因是不稳定和假体周围骨折，而2年以上的翻修原因是聚乙烯磨损。90天后的翻修更有可能需要后续再次翻修，且90天再入院率或感染率没有增加。
回顾性队列研究。
