Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 26178
OUTCOME OF MODERN REVISION HIP ARTHROPLASTY FOR ASEPTIC
LOOSENING.
Maung WIN HTEIN, Syah BAHARI, Sinead O'DWYER, Finbarr CONDON
Department of Joint Reconstructive Surgery, Limerick (IRELAND)
Introduction: Complications associated with revision hip arthroplasty were historically
reported to be higher than primary hip arthroplasty. Approximately 10% risk of
surgical site infection, 15% risk of dislocation, 10% risk of intra operative fracture and
3% risk of sciatic nerve injury were identified as the main complications. In modern
revision hip arthoplasty, advance surgical technique, availability of modular
prosthesis and improved anti sepsis, we questioned the validity of these figures.
Patients and Methods: Patients were prospectively identified and follow up from our
hip arthroplasty registry. Only patients undergoing revision for aseptic loosening were
recruited. Demographic data, surgical approaches, implant types, position and
complications were collected. Surgical site infection, intra or postoperative fracture,
dislocation and sciatic nerve injury were used as outcome end points. Harris hip
score was used as a measure for clinical outcome. Results: 52 patients were
identified and follow up. All hips were revised from a posterolateral approach.
Extended trochanteric osteotomy was used if cement removal required. Cement in
cement technique was used if cement mantle was satisfactory. Femoral head
allograft and trabecular metal were used for augmentation of bone stock. The
incidence of surgical site infection, dislocation, fracture and sciatic nerve injury were
3.2%, 1.7%, 0.4% and none respectively. Conclusion: With improvement in surgical
technique, prosthesis modularity and anti sepsis regime; complications such as
surgical site infection, dislocation, fracture and nerve injury is less than previously
reported. Utilising appropriate surgical approach, implant combinations will provide
optimal stability and satisfactory outcome.
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