DOS Kongressen 2014 ·
63
Re-revision rates following revision of cemented and
cementless primary hip arthroplasty
Kirill Gromov, Alma Pedersen, Søren Overgaard, Peter Gebuhr, Henrik Malchau,
Anders Troelsen
Department of Orthopaedic Surgery, Copenhagen University Hospital
Hvidovre; Department of Clinical Epidemiology, Aarhus University Hospital;
3Department of Orthopaedic Surgery, Traumatology and Clinical Institute,
Odense University Hospital; Orthopaedic Department, Massachusetts General
Hospital
Background:
Increased use of cementless technique for primary THA in most
parts of the world can lead to changes in reoperation patterns, ie indications for
revision, and potentially influence the survival of revision arthroplasty.
Purpose / Aim of Study:
In this registry-based study we wanted to investi-
gate the role, primary femoral fixation plays in survival of revision arthroplasty.
Materials and Methods:
Primary THA’s with cemented (n=1889) and unce-
mented (n=805) femoral component that subsequently sustained 1st revision
of femoral component were identified from the Danish Hip Registry. Survival
of 1st revision THA, with 2nd revision of the femur as outcome, was evaluated
using cox regression analyses to calculate adjusted hazard ratios (HR). Patient
demographics, time until revision, indications for revision and femoral bone de-
fects at the time of 1st revision were also recorded.
Findings / Results:
Adjusted HR for 2nd revision due to any reason of cement-
less compared with cemented primary THA with 1st revision was 1.36; 95%CI
(1.02 -1.83). 71.6% of cemented primary THAs were revised due to aseptic
loosening; while 46.1% of cementless primary THAs were revised due to femo-
ral fracture. 3.6% of revisions on cemented primary THAs were performed <1
year after index surgery, compared to 37.1% of revisions on cementless THA’s
when only looking at revisions performed due to aseptic loosening.
Conclusions:
We found significantly increased risk of 2nd revision after 1st re-
vision performed on primary cementless THA compared to cemented THA con-
sidering all causes for revision. Different indications for 1st revision could po-
tentially explain inferior survival of revision performed on cementless THA. Our
data suggest that increased use of cementless fixation in primary THA might
lead to inferior survivorship of 1st revision THA.
10.
