REVIEW AND ANALYSIS OF REVISION OF TOTAL HIP REPLACEMENT

Objective To evaluate the clinical value of the revision of total hip replacement(THR), to analyse the reason of the revisions, and to discuss the main difficulties and measures to manage it. Methods From June 1998 to January 2002, 15 cases (15 hips) were revised on total hip replacement. The reasons for revision in the cases were as follows:failure of primary operative techenique, loosening and sinking of the components, displacement of the prosthesis, erosion of the acetabulum, as well as fracture of the femoral stem. The main difficulties of the revision were:poor health condition of the patients; the remove of the prosthesis of the primary THR, especially the broken femoral stem and the cements; the loss of local bone. The measures to remove the broken femoral stem were described. Results All cases were followed up 2.4 years on average: 2 patients died from heart disease and cerebrovascular disease respectively, while the good results were achieved in the others. No infection, dislocation, loosening, and other complications occurred. The good effects were related with following factors:mild degree of illness; no severe bone defect; most of the first femoral head replacement. Conclusion The revision of THR is a more difficult operation, so that the special instrument and equipment and operative experience are required.