© 2013 Wichtig Editore - ISSN 1120-7000
Hip Int ( 2013 ; : 2 ) 162 - 165 23
162
Revision hip replacement in patients 55 years of age
and younger
Sujith Konan, Agustine Soler, Fares S. Haddad
Department of Trauma and Orthopaedics, University College Hospital, London - UK
ABSTRACT: The purpose of this study was to assess the efficacy and complications associated with revi-
sion hip arthroplasty undertaken in patients under 55 years of age.
A review of our revision hip database showed that 430 revision hip arthroplasties undertaken over
the past 9 years had a minimum follow-up of 2 years. Of these, 84 (46 female, 38 male) patients were
under 55 years of age. The index procedures were preformed at an average age of 46 years (range
15 years to 54 years). The etiology of failure was aseptic loosening (74%), followed by infection (8%)
and recurrent dislocation (7%). In the majority of cases, uncemented implants were used at revision
surgery (91% uncemented femoral stem, 100% uncemented acetabular cup). A form of bone graft
was necessary in 39% of cases.
At final follow-up satisfactory progress was noted in all cases with a statistically significant improve-
ment in Harris hip score (p<0.05).
Revision of hip arthroplasty in patients below 55 years of age is associated with significant improve-
ment in function and patient satisfaction.
KEY WORDS: Hip revision, Hip revision in young patient, Revision arthroplasty
Accepted: November 29, 2012
ORIGINAL ARTICLE
DOI: 10.5301/HIP.2013.10814
INTRODUCTION
Total hip replacement has become one of the most suc-
cessful orthopaedic procedures. With improvements in
metallurgy and bearing surfaces, the indications for this
procedure have become broader. Not only are hip replace-
ments being offered to the more active patients, but they
are also offered as a solution to hip pathology in the young-
er patient. Implant loosening in young patients who have
undergone cemented total hip replacements and poor
results of cemented revisions have been reported (1-4). It
has been postulated that high patient activity levels and
implant stresses contribute to early failure and therefore,
the need for early revision arthroplasty.
The aim of this study was to review the efficacy, complica-
tions and outcomes of revision hip replacement in patients
under 55 years of age.
METHODS
A review of our revision hip database showed that 430
revision hip arthroplasties undertaken over the past nine
years had a minimum follow-up of two years. Of these,
84 patients were under the age of 55 years at the time of
the revision procedure. There were 46 male patients and
38 female patients in this cohort and the mean age at
the time of surgery was 46 years (range 15-54 years). The
minimum follow-up was two years (mean 5.2 years, range
2-9 years). The mean interval from previous hip proce-
dure to revision hip surgery was 9 years (range 0-7 years).
Sixty-one patients had cemented femoral stems and thirty
eight patients had cemented acetabular cups. Cementless
acetabular cups were present in 46 patients and cement-
less femoral stems in 23 patients. Seventy-four patients
were undergoing their first revision, seven their second and