Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 26179
REVISION RATE AFTER TOTAL HIP ARTHROPLASTY – SOME COMBINATIONS
OF
IMPLANT AND SURGICAL APPROACH ARE MORE FAVOURABLE
Viktor LINDGREN 1 , Johan KÄRRHOLM 2 , Göran GARELLICK 2 , Per WRETENBERG 1
1 Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm
(SWEDEN), 2 Department of Orthopaedics, Mölndal (SWEDEN)
Aim: The aim of the following study was to analyse if there is a relation between type
of surgical approach and revision rate for total hip arthroplasty (THR). Material and
methods: Data from the Swedish Hip Arthroplasty Register was used from 1999 -
2008. The three most commonly used prosthesis were Charnley (13500), Lubinus
SPII (73000) and Exeter Polished (30500). Risk for revison calculated as adjusted
risk ratio (RR) for all causes was analysed using Cox regression with correction for
gender, age, and preoperative diagnosis. In the study the anterolateral approach was
compared to the posterolateral approach. Results: Posterolateral incision increased
revison rate because of dislocation for all three different types of implants. The risk of
revision because of infection did not vary with different approaches or implants.
Posterolateral approach increased the risk of femur fracture in combination with the
Exeter prosthesis but decreased in combination with the Charnley prosthesis. The
risk of revision because of loosening was lower with a posterolateral approach in
combination with the Charnley and Lubinus prosthesis (RR: 0,5, 95% CI: 0,4-0,7 and
0,8; 0,6-0,9) but higher with the Exeter prosthesis (RR: 2,9, 95% CI 2,0-4,0).
Discussion: This study signifies that the risk of revision in different kinds of prosthesis
systems varies with the surgical approach. The reason for this is perhaps that the
correct positioning of prosthesis is more or less difficult when using a posterior or
anterolateral approach because of the design of the prosthesis.
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