Causes of revision after total hip arthroplasty in patients undergoing revision total hip arthroplasty younger than 50 years of age

Abstract

Background and Aims: Young patients undergoing revision total hip arthroplasty (THA) have different indications and causes of failure of THA. This retrospective cohort study examines the causes of failure of THA in a patient younger than 50 years. Subjects and Methods: Clinical and demographic data of 146 revision THA (130 patients) were gathered from case records of patients who underwent revision THA at our institute between January 1, 2018, and December 31, 2021. Fifty-two hips (46 patients) were younger than 50 years at the time of revision. Baseline characteristics, cause for revision, implants revised, and duration of survival were noted. Statistical Analysis: Chi-squared test was implemented to find a correlation, and P < 0.05 was considered statistically significant. Results: We had 52 hips, 46 patients (28 females), and the mean age at primary THA was 33.9 years, the mean age at revision THA was 44.5 years, and the mean survival of implants was 10.6 years. The most common diagnosis for primary THA was avascular necrosis of the femoral head (21 hips, 40.38%), followed by inflammatory arthritis. The most common cause of failure was aseptic loosening (27 hips, 51.92%). As compared to the overall population undergoing revision THA (60/146 hips, 41.09%), patients younger than 50 years having more frequency of aseptic loosening as a cause of failure of THA and less frequency of periprosthetic joint infection, instability, and fracture; but statistically significant difference was not found (P = 0.38). No correlation was found between the type of implants used (P = 0.84) and diagnosis at index THA (P = 0.78), with the cause of failure of THA. Conclusions: Aseptic loosening of THA is the most common mode of failure in patients younger than 50 years.