Changing Indications for Revision Total Hip Arthroplasty

This was a retrospective review of two cohorts of 100 consecutive revisions performed 10 years apart
by one surgeon, to determine the major reason for reoperation. For the early cohort, the indications for
revision were: loosening of both components (38%), loosening of acetabular component (22%), loose
hemiarthroplasty (13%), infection (10%), loosening of femoral component (8%), periprosthetic fracture
(6%), recurrent dislocation (2%), and wear (1%). For the recent cohort, the indications for revision have
significantly changed: loosening of acetabular component (24%), loosening of femoral component (22%)
(p D .0048), recurrent dislocation (16%) (p D .0011), loosening of both components (15%) (p D .0002),
wear-osteolysis (7%) (p D .03), infection (7%), loose hemiarthroplasty (6%), and periprosthetic fracture
(3%). There has been a change in the indications for revision hip arthroplasty compared with 10 years
ago, with a statistically significant increase in revisions for dislocation, wear-osteolysis, and loosening of
the femoral component only. (Journal of Surgical Orthopaedic Advances 14(2):82–84, 2005)
Key words: dislocation, revision hip arthroplasty, wear