Revision of bilateral total hip arthroplasty for failed primary arthroplasty: a case report

Total hip arthroplasty (THA) remains one of the commonest as well as most advanced surgical procedures performed since the 20th century. Due to its prevalence among orthopedic surgeons, it follows that the rate of revision THA will surge in tandem. Some reasons for this include complications of primary THA such as Osteolysis, aseptic loosening and infection of bearing surfaces. The aim of this study was to present the management approach for a complicated bilateral revision THA. In this case we considered a 51-year-old female with a history of bilateral recurrent hip pain for more than ten years, aggravated for the past 1 year. She presented to the outpatient department of Southeast University Affiliated to Zhongda Hospital, Nanjing, China, on February 2017. She had a history of hypertension for more than ten years with nephritis as co-morbidity. She has a past history of twicely performed bilateral total hip replacement due to femoral head avascular necrosis. On further examination, lumbar, pelvic and bilateral hip axial radiography showed: Bilateral Hip Replacement Variations; Pelvic and Bilateral Hip Degeneration; Lumbar L4-5 vertebral Compression and Osteoporosis. This then informed the surgeon's decision to perform revision THA. Six months later, follow up showed no complications. Although revision THA is a complicated surgical procedure, it remains one of the most successful treatment options for failed primary THA. But before reaching this conclusion, a detailed assessment is necessary.