4.4 Article

Outcome of revision surgery for adverse local tissue reactions in patients with recalled total hip arthroplasty

Journal

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Volume 142, Issue 10, Pages 2577-2583

Publisher

SPRINGER
DOI: 10.1007/s00402-021-03891-3

Keywords

Adverse local tissue reaction; Dual taper neck-stem; Metal-on-metal bearing; Recalled hip implant; Total hip arthroplasty; Post-revision complication

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This study reveals high complication and reoperation rates of recalled THAs at mid-term follow-up, with revision of modular taper corrosion THA and high-grade intraoperative tissue damage posing as risk factors for post-revision complications.
Introduction Recalls of total hip arthroplasty (THA) implants, including metal-on-metal (MoM) THA and dual taper stems, due to increased risk of adverse local tissue reaction (ALTR), represent a challenge for both surgeons and patients. This study aims to analyze the revision surgery outcomes for ALTR in patients with recalled THA implants. Methods A total of 118 consecutive patients who underwent revision surgery due to ALTR with recalled THA were analyzed. Sub-group analysis was performed for recalled MoM THAs, head-neck modular stems, and dual taper neck-stems. Results At a mean follow-up of 6.6 years, the complication and reoperation rates of the recalled THAs were 32.2% and 25.4% respectively. The most common post-revision complication was dislocation (16%). Revision of modular taper corrosion THA and high-grade intraoperative tissue damage were risk factors associated with post-revision complications. Conclusion This study reports high complication and reoperation rates of recalled THAs at mid-term follow-up. The high revision surgery complication rates in both groups suggest the importance of a systematic evaluation of all THA patients with at-risk implants.

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