Multiple Revision Surgeries and Acetabular Bone Defect Size May Predict Daily Activity After Revision Total Hip Arthroplasty

Background: We identified preoperative predictors and size of acetabular bone defects for poor return to daily activity after revision total hip arthroplasty. Methods: Our analysis was based on outcomes of 140 cases of revision total hip arthroplasty, performed for any reason between May 2001 and March 2013. The Japanese Orthopaedic Association (JOA) score and body mass index (BMI) measured preoperatively, and the University of California Los Angeles (UCLA) activity score and JOA score measured at the 2-year follow-up were evaluated. Acetabular bone defects were classified according to the American Academy of Orthopaedic Surgeons grading system, with further classification of the location and severity of each acetabular bone defect. We compared preoperative clinical factors and postoperative clinical outcomes statistically. Results: We found a significant association between the number of revision surgeries and worse postoperative JOA scores and UCLA activity scores. There were significant differences in postoperative JOA scores and UCLA activity scores between patients with partial and global acetabular bone defects. Conclusion: Multiple revision surgeries and the size of the acetabular bone defect were predictors of both poorer clinical outcome and greater restriction in postoperative daily activities. Closer attention to the postoperative management of patients with a lower preoperative status is warranted. (C) 2016 Elsevier Inc. All rights reserved.