Midterm Outcomes of Revision Total Hip Arthroplasty Using a Modular Revision Hip System

Background: The growth in hip arthroplasty surgery has meant a corresponding escalating revision burden with increasing challenges for the orthopaedic surgeon. The purpose of this study was to review clinical outcomes of a modular revision hip system within a single institution. Methods: We retrospectively reviewed a cohort of modular revision hip system stems performed in our institution between January 2005 and October 2012 giving a potential minimum follow-up of 2 years. Clinical outcomes data on complications, Oxford Hip Score (OHS, 0-48) and patient satisfaction were collected. Radiographic outcomes including subsidence were assessed. Implant survival was estimated using Kaplan Meier analysis. Results: 115 stems in 106 patients were identified. All cause survival was 82% (95%CIs: 73%-89%) at 6.1 years; survival excluding infection being 99% (95%Cls: 93%-100%). There was a low incidence of subsidence (seven stems) and no peri-prostheticfractures. Primary cause of re-revision in this series was re-infection with only one re-revision for mechanical failure. Median Oxford Hip Score at mean follow up 4.1 years (2-9) was 40 (14-48) and 93% of patients reported being satisfied with their revision surgery. Conclusion: This study showed good clinical outcomes and survival using a modular revision stem with low mechanical failure and subsidence. Recurrence of infection remains a challenge in revision surgery.