Comparison of patients undergoing revision total hip arthroplasty and patients undergoing re-revision

Abstract

- OBJECTIVE: The aim of this study is to compare the demographic, clini-cal, and surgical characteristics of patients who underwent revision hip replacement sur-gery and those who underwent re-revision sur-gery. The secondary outcome is the investiga-tion of the factors that play a role in estimating the time between primary arthroplasty surgery and revision surgery.PATIENTS AND METHODS: The patients who underwent revision hip arthroplasty in our clinic between 2010-2020, patients with at least 2 years of follow-up, and who underwent re-revision surgery if needed were included. Demographic and clinical data were investigated. RESULTS: Of the 153 patients who met the study criteria, 120 (78.5%) underwent revision (Group 1) and 33 (21.5%) underwent re -revi-sion (Group 2). The mean age of Group 1 was 53.5 (32-85), and of Group 2 was 67 (38-81) (p=0.003). In both groups, patients who un-derwent hip replacement due to fracture had more revisions and re-revisions (p=0.794). While 53.3 of the patients in Group 1 did not need additional implants, 72.7% of the pa-tients in Group 2 needed additional implants (p=0.010). Fracture-dislocation, fistula, and the need for debridement after the revision were statistically significantly higher in pa-tients who underwent re-revision. Harris hip scores (HHS) were statistically lower in pa-tients who went for re-revision. CONCLUSIONS: The need for reoperation in patients who have undergone revision total hip arthroplasty (THA) surgery is due to the fact that the patient's age is advanced and the indi- cation for surgery is a fracture. While the rate of fistula, fracture, dislocation, and debride- ment increases after re-revision surgeries, the HHS values that indicate clinical success also decrease. We believe that studies with larger participation and longer follow-up periods are needed to explain this issue better.