A multicenter 10-year study of cemented revision total hip arthroplasty in patients younger than 55 years old. A follow-up report.

In 1988, the authors reported the results of 67 cemented revision total hip arthroplasties performed for aseptic loosening in patients younger than 55 years old. Both components were cemented at both the primary operation and revision. With an average follow-up period of 4 years, 14 hips (21%) required a second revision arthroplasty. Eight hips in this study group were revised using the Christiansen prosthesis, which is known to have a high failure rate and is, consequently, not in use anymore. Therefore, these eight hips have been excluded from this extended follow-up study. The authors were able to follow the remaining 59 hips for an average of 10 years (range, 8-13 years). In all, 49 hips (83%) were rerevised or radiographically loose or painful. Nevertheless, 75% of the patients, rerevisions included, were satisfied with the final result. There was an increase in bone loss at the final follow-up visit compared to the initial revision, reducing the prerequisites for a good result if further revision surgery was to be performed. After 10 years, survivorship analysis depicted a 48% survival rate when rerevision for aseptic loosening was considered a failure. The survival rate was 65% for the cup and 61% for the stem. The authors conclude that there is an increased failure rate with longer follow-up periods for cemented, revision total hip arthroplasties in young and active patients, and therefore, these patients must be followed indefinitely. The long-term results in this study provide an opportunity for valid comparisons of more sophisticated surgical techniques.