FOLLOW-UP OF TOTAL HIP ARTHROPLASTY: IS COLLECTING FAILED CASES A GOOD APPROACH? THE AVIO EXPERIENCE 1996–2000

Abstract

Purpose: Following up patients who have undergone total hip arthroplasty (THA) is useful but raises many technical and logistic problems. A systematic analysis of data collection for THA patients allows an evaluation of the value and the limitations of the method.

Material and methods: During a five-year period, French, Belgium, and Spanish surgeons volunteered to participate in the AVIO program. For all revision THA, they completed a brief information card recording data on the patient, the reason for the revision, the type of prosthesis replaced, its current status and the status of the bone. Data were centralised for statistical analysis. More than 3000 information cards were collected. Analysis provided information on the patients (age, gender, side, etc.) but also on survival of the revised prostheses, the principal reasons for revision, and the anomalies observed on the implants and bones and the relationships between these points.

Results: The reasons for revision could be divided into two categories: early problems (dislocation, infection, pain) and late problems (loosening, bone lysis, dislocation). Revisions directly related with defective material accounted for only 5% of the cases but a default was present in 75% of the cases at revision.

Discussion: This work provides interesting insight into revision THA and the patients concerned as well as the limiting technical problems. Conversely, it did not reveal any significant indication concerning the outcome of the prostheses themselves due to lack of information on first-intention implantation. Systematic data collection was also hindered by several factors: irregular mailings, imprecise information, difficulty in determining which implant was removed.

Conclusion: Systematic collection of data on technical failures can provide useful information on the technique, but cannot allow in itself a valid evaluation.