Survivorship and Risk Factors for Re-Revision after Aseptic Revision Total Hip Arthroplasty in Patients Aged ≤55 Years

Background: There is a relative paucity of literature on the outcomes after revision total hip arthroplasty (rTHA) in young patients. This study reports the survivorship and risk factors for re-revision in patients aged <= 55 years. Methods: We identified 354 patients undergoing aseptic nononcologic rTHA at mean follow-up of 5 years after revision, with mean age of 48 years, body mass index of 28 kg/m(2), and 64% female. Thirty-five (10%) patients underwent at least 1 previous rTHA. The main indications for rTHA included wear/osteolysis (21%), adverse local tissue reaction (21%), recurrent instability (20%), acetabular loosening (16%), and femoral loosening (7%); and included acetabular component-only rTHA in 149 patients (42%), femoral component-only rTHA in 46 patients (13%), both component rTHA in 44 patients (12%), and head/liner exchanges in patients 115 (33%). The Kaplan-Meier method was used to measure survivorship free from re-revision THA, and multivariate regression was used to identify risk factors for re-revision THA. Results: Sixty-two patients (18%) underwent re-revision THA at the mean time of 2.5 years, most commonly for instability (37%), aseptic loosening (27%), and prosthetic joint infection (15%). The rTHA survivorship from all-cause re-revision and reoperation was 83% and 79% at 5 years, respectively. Multivariate analysis demonstrated that patients undergoing femoral component only (hazard ratio 4.8, P = .014) and head/liner exchange rTHA (hazard ratio 2.5, P = .022) as risk factors for re-revision THA. Conclusion: About 1 in 5 patients aged <= 55 years undergoing rTHA required re-revision THA at 5 years, most commonly for instability. The highest risk group included patients undergoing head/liner exchanges and isolated femoral component revisions. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

There is limited literature on the outcomes of revision total hip arthroplasty (rTHA) in young patients. This study examined the survival rate and risk factors for re-revision in patients aged <= 55 years. Approximately 1 in 5 patients required re-revision THA at 5 years, with instability being the most common reason. Patients undergoing head/liner exchanges and isolated femoral component revisions were found to have the highest risk.