Kompendium 2020 Forschung & Klinik

TOP-Studien
50
A
B
C
Figure 1: Case: male patient borne 1939;
An arthrodesis of his right hip was performed
in 1956 after seven years of conservative
treatment for tuberculosis. In 1979 his left hip
was treated with a Chiari PO for dysplasia with
subluxation. In 1992 the patient underwent THA
on the right side and in 1995 (16 years after PO)
on the left side. Latest FU 2017 (22 years after
THA): the patient’s satisfaction was good, the
Trendelenburg sign was positive, he showed
almost no pain and good mobility.
(A) Preoperative X-ray
(B) Post PO left (1979)
(C) 1 Year post -PO left (1980)
(D-E) implantation of THA 1995, X-ray
22 years post THA (2017)
D
E
Radiological Evaluation and Results
60 patients with 74 hips attended the radiological follow up. We compiled the
inclination angle of the acetabular cup, signs of radiolucency, ossifications,
and the presence of acetabular roof plasty. The overall survival (OS) of the THA
after 8-, 10-, 20- and 25 years was 95%, 93%, 76% and 68%, respectively.
„This retrospective study supports the
hypothesis that prior CPO does not compromise
the prerequisites for successful
conversion THA at a later stage.“
Eleonora Schneider
12% (N=37) of all patients underwent a revision THA procedure after an
average time period of 9.6 years (±6.1; range 4 months-25.4). Four patients
(11% of all revisions) underwent revision surgery within two years after THA.
Two patients had the acetabular component revised (50% of the early revision),
one for aseptic loosening after four months, the other for breakage of the acetabular
component after nine months. One patient had a total revision (25%)
for aseptic loosening and shaft fracture after 23.9 months. One patient underwent
revision surgery at another hospital due to unknown reasons (25%)
after twelve months. Of the remaining 33 patients one third needed revision
of the acetabular component (N = 11, 33%). Reasons for acetabular revision
surgery were twice aseptic loosening, one dislocation of the component and
once wear. In seven cases the patient could not specify the reason. Total revisions
were performed in nine patients (27%; 3 aseptic loosening, 1 infection,
1 luxation, 3 unknown). Seven hips (21%) had the head and inlay revised, the
reason being excessive wear in five of them, and no identifiable reason in the
other two. Three femoral stems had to be revised for unknown reasons (9%).
In one patient a Girdlestone surgery was performed due to infection (3%). Two
patients reported on a revision surgery on the phone but could not give any
valid details on reason or extent of the performed procedures (6%).
Neither patient’s age at the time of CPO (p= 0.199) nor the age at the time of
THA (p = 0.210) had significant influence on the incidence of revision surgery.
Out of 245 patients (301 hips), 81 were clinically investigated and nine of
them (11%) reported about early complications: two intraoperative femoral
fractures, two postoperative deep venous thrombosis, and five postoperative