061 REVISION TOTAL HIP REPLACEMENT. PROBLEMS – COMPLICATIONS

Abstract

The revision of the hip surgery belongs to the major orthopaedic surgery and the purpose of our research is the presentation of our experience.

During the period 2004–2008, revision in surgery of the hip was performed in 15 patients, while most of them were women with average 73 years. 190 subcapital fractures were revisioned in 7 patients, 277 pertrochanteric fractures in 3 patients, 75 total arthroplasties in 5 patients and all of them were bipolar arthroplasties and osteosynthesis with DSH plate. The average interval between the primary operation and revision arthroplasty was 28 months, revision of the acetabular was performed in 3, revision of the femoral in 1 and regarding to the other patients both types of revision were performed. According to Paprosky classification we noted lesions of type I and type II and in 13 cases operation was made in a time. Early complications appeared in 6 patients (mostly postoperative infections). For the stabilization of the acetabular we used supporting rings with bone grafts or press fit acetabulars without cement, while for the femoral, according to the injury extend and the bone quality, the stabilization of the stem was made with cement. The average follow-up time was 20 months, we re-examined 14/15 patients and chronic complications appeared in 2 patients. The final result was satisfactory, according to Harris-Hip score with the radiological evaluation.

Conclusively, hip revisions are difficult and demanding operations, accompanied by serious complications. For their success good preoperative planning, experience and complete material-technical supporting are required with use, most of the times, of custom made prosthesis, supporting rings of the acetabular with bone graft.