Re-interventions and mortality in revision total hip replacement in the Hospitals San José and Infantil Universitario de San José, 2009-2012
DOI:
https://doi.org/10.1016/j.rccot.2017.01.001Keywords:
hip replacement surgery, re-operation, mortality, case studiesAbstract
Background: Revision total hip replacement surgery is more serious than the primary intervention, and prognosis is directly affected by the findings, surgical complications, re-operations, and patient sociodemographic characteristics.
Materials and methods: A descriptive study was conducted on a case series of patients between 30 and 95 years-old who underwent total hip replacement revision in San José Hospital and the San José University Children’s Hospital between January 2009 and July 2012. Their demographic and clinical data were stored in a database and analysed using descriptive statistics.
Results: The study included 70 patients with mean age 63 ± 14 years, with 38 (54%) women. The causes of primary revision were: aseptic loosening (44%), septic loosening (33%), prosthetic dislocation (17%), and peri-prosthetic fracture (6%). The mean surgical time was 142 ± 68 minutes for the first revision and 133 ± 19 minutes for the second revision. The maximum number of revisions was 2, but the number of re-operations for other reasons was higher. The main causes of re-operation were: superficial surgical site infection (63.15%), prosthetic dislocation (15.7%), peri-prosthetic fracture (11%), and deep surgical site infection (5.2%). Early mortality during the initial revision was 0%, while for the second re-operation and revision time, it was 5% and 11%, respectively.
Discussion: The causes of primary revision and re-intervention found in this study are consistent with those reported in the literature. The subsequent re-operations are common and are associated mostly to peri-prosthetic fractures and infections. Fractures were the main intra-operative complication and mortality was associated with infection.
Evidence level: IV.
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