Abstract
1069 primary hip arthroplasty (THA) (416 males) and 1846 revision (798 males) patients were matched for sex, age and date of primary THA. Data were collected via retrospective chart review. Time to revision averaged 9.5 years. Revision THA patients were younger at primary THA (55 vs. 64 years), had a higher body mass index (27 vs. 30) and more frequently had a cemented acetabulum (p< 0.0001). After controlling for institution, earlier time to revision was predicted by younger age at primary THA, secondary OA or dysplasia, increased BMI, posterior surgical approach, cemented acetabulum, and small femoral head size (28 mm) (p< 0.05).
To determine whether patient (age, gender, underlying disease, body mass index), surgical (surgical approach), and prosthetic (cemented vs. uncemented acetabular or femoral component, femoral head size) factors predict time to revision arthroplasty of primary total hip arthroplasty (THA).
Patients who are younger when undergoing primary THA, have secondary osteoarthritis (OA) or dysplasia, are obese, and have a cemented acetabulum with a small femoral head by a posterior approach are at increased risk for revision THA.
This study identified important, potentially modifiable patient, surgical and prosthetic factors that are adverse predictors of outcome.
For the period 1980 to 2000, 1069 primary hip arthroplasty patients (416 males) and 1846 revision arthroplasty (798 males) patients were matched for sex, age and date of primary THA within two years. Revision THAs for infection were excluded. Data were collected via retrospective chart review. Time to revision THA averaged 9.5 years. In univariate analysis, patients who had revision THA were younger at primary THA (55 vs. 64 years, p< 0.0001), had a higher body mass index (BMI) (27 vs. 30, p< 0.0001), and more frequently had a cemented acetabulum (p< 0.0001). After primary THA, fewer patients who went on to revision arthroplasty had orthopaedic complications (6.5 vs. 16.5%). After controlling for institution, earlier time to revision was predicted by younger age at primary THA, underlying joint disease of secondary OA or dysplasia, increased BMI, posterior surgical approach, cemented acetabulum, and small femoral head size (28 mm) (multivariate Cox model, p< 0.05).
Funding: This work was supported in part by a grant from the Canadian Orthopaedic Foundation and The Arthritis Society
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
