CATASTROPHIC FAILURE ASSOCIATED WITH THE WAGNER HIP RESURFACING PROSTHESIS AND THE IMPACT ON SUBSEQUENT REVISION SURGERY

Hip resurfacing is a procedure designed to conserve bone stock in the younger patient and facilitate revision to a total hip arthroplasty if the need arises. The Wagner Hip Resurfacing (WHR) was a metal-on- poly implant introduced in 1978. The notes and radiographs of 16 patients who underwent 19 WHR procedures performed by a single surgeon between 1980 and 1984 were reviewed. The mean age at primary surgery was 54 (range 41–68). 16 of the WHRs required revision at a mean time of 45 months (range 1–144 months). 3 WHR had not been revised: one is functioning at 22 years, one functioning well 20 years after implantation when the patient died and 1 non-functional 9 years after implantation due to femoral head reabsorption. The reason for revision was femoral neck fracture (3), femoral head collapse / avascular necrosis or loosening (8), acetabular loosening (5). Subsequent problems with the revision were noted in 6 patients (2 dislocations, 2 infections, 1 acetabular loosening and 1 femoral loosening). 3 patients ended with a Girdlestone excision arthroplasty and 2 required re-revision. Hip resurfacing is designed as a conservative option for the young arthritic hip. This prosthesis not only failed catastrophically at an early stage but had a major subsequent impact on revision surgery and complications associated with it.