Risk factors for revision total hip arthroplasty: emphasis on the characteristics of Japanese lifestyle

Total hip arthroplasty (THA) is a common technique for increasing quality of life (QOL) in patients with degenerative or traumatic hip arthropathy. However, there is always a risk of THA requiring revision. The present study aimed to develop guidelines for QOL assessment and patient education by analyzing the risk factors for revision THA. In 136 patients who underwent THA (revision group: n = 52 and no revision group: n = 84), a self-administered questionnaire survey was conducted. Logistic regression analysis was used to investigate the risk factors for THA, and McNemar's test was used to compare the changes in living postures before and after surgery between the two groups. The following risk factors for revision were extracted by logistic regression analysis: dislocation after primary THA (OR: 10.5; 95% CI: 1.0-106.7), insufficient advance preparation of living aids (OR: 5.0; 95% CI: 1.6-15.8), and discouraged toileting postures (OR: 11.3; 95% CI: 1.1-115.9). In the postoperative period, the proportion of recommended postures while eating, toileting, bathing, sleeping, and resting was significantly higher for the no revision group (P < 0.001). The results suggest that recommended living postures, advance preparation of living aids, and dislocation prevention after THA are efficient indicators for assessing the risk for revision THA while emphasizing aspects of the Japanese lifestyle that require considerable hip joint range of motion.