Abstract
Most early failures of THA are related to patient factors and technical “surgeon” factors. Most late failures of THA are related to patient factors and device factors. Occasionally unexpected device-specific failure modes cause specific early failure patterns. The most common reasons for early THA failure are infection and instability. Infection risk is strongly influenced by patient factors. Instability early after THA is usually a technical problem, but at times also is patient related. Important late failure modes of THA include loosening, wear and osteolysis, and periprosthetic fracture. Loosening and wear are at least in part device related. Late periprosthetic fracture is almost mainly patient related.
Taken together these data suggest the following:
Most strongly related to patient factors: Early and late infection, periprosthetic fracture and wear and osteolysis.
Most strongly related to surgeon factors: Early infection, instability, and loosening.
Most strongly related to device factors: Wear, loosening, and unique mechanical implant failure modes.
