Revision of Total Hip Replacement
10.4055/jkoa.1988.23.1.173
- Author:
Han CHANG
;
In KIM
;
Seung Koo LEE
;
Jung Man KIM
;
Ick Soo WHANG
- Publication Type:Original Article
- Keywords:
Hip;
Total replacement;
Complications;
Treatment;
Revision operation
- MeSH:
Arthroplasty;
Arthroplasty, Replacement, Hip;
Femur;
Follow-Up Studies;
Head;
Hip;
Humans;
Incidence;
Legg-Calve-Perthes Disease;
Medical Errors
- From:The Journal of the Korean Orthopaedic Association
1988;23(1):173-183
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The successful development of reliable total hip arthroplasties for the treatment of several diseased hips has led to it increasing application in this country. As with any mode of therapy, the more frequent its use, the greater chance of complication or failure. Infection and loosening of component which is mainly due to improper surgical and cementing technique are the most frequent of these complication and has been increased the incidence of revision, too. We have experienced 96 hips of total hip replacement in 90 patients from February 1980 to July 1986. Among them, 14 hips who had been undertaken revisional arthroplasty were followed-up for average 27 months, and the following results were obtained. 1. Average patients age was 50.5 years, and time from previous total hip replacement to revisional arthroplasty was 3 years in 11 cases of loosening but only 3 weeks in 3 cases of surgieal error, and the post-revision follow-up was average 27 months. The main cause of the revisional surgery in this study were aseptic loosening in 9 csses (64.3%), surgical error in 3 cases(21.4%) and septic loosening in 2 cases(14.3%). 2. Cementless total hip replacement seems to be more prefer in an attempt to in initial total and even in revisional hip replacement to prevent loosening. 3. There are three cases of surgical error with the fracture and penetrating the tip of femoral stem into the proximal femur. Their causes of initial hip arthroplasty wss dysplastic hip in one and two cases of secondary osteosrthritis due to late sequelae of Legg-Calve-Perthes disease with moderate degree of anteversion of femoral head. These patients were younger than most who require usually total hip replscement and therefore their bone was harder and the medullary canal was nsrrow. These surgical complications are initiated because any attempt to correct these anteversion of femoral head was not given preoperatively. These kinds of surgical error in total hip replacement can be prevented by careful anstomicsl and radiological analysis of proximsl femur preoperatively, and X-rays or viewing with the T-V image intensifier for the proximal femur during the operation.
