Risk of revision hip surgery

A hip replacement is an operation that has been carried out for decades. It is a cost-effective procedure, with well-established benefits, in particular, relief of pain and getting people back to normal function.

Total hip replacements are being carried out on more and more younger patients, thanks to a variety of factors which have made this age group more requiring of this type of procedure, including more active lifestyle choices and advancements in medical knowledge and processes.

A recent study, looking at data from the Dutch Arthroplasty Registry (LROI), set out to explore the risk of revision hip surgery in patients undergoing this type of operation, with a particular interest in understanding whether or not there are any differences for younger patients. The term ‘revision rates’ means how many patients had repeat or follo- up surgery following the initial operation.

Data from almost 20,000 patients was analysed, making this a statistically robust assessment. All patients whose data was examined were younger than 55 years old and had undergone a total hip replacement in the Netherlands between the years of 2007 and 2017. This data was then scrutinised looking for any difference in the following areas:

Potential risk of revision hip surgery factors:

  • Age
  • Sex
  • Diagnosis
  • ASA-classification
  • Surgical approach
  • Fixation method
  • Bearing type
  • Head size
  • Year of surgery

The research concluded that “the risk of revision hip surgery in patients younger than 55 years depends on surgical approach, head size and bearing type. The anterior approach resulted in a decreased risk of revision, whereas the use of ≥38 mm heads and MoM bearings resulted in an increased risk of revision for any reason.” So, a variety of factors could be expected to affect the longevity and risk of revision in younger patients.

Total hip replacements in younger patients have helped many people live with a better quality of life, with reduced/lack of pain and much greater levels of mobility than they were able to achieve prior to opting for the treatment.

According to results of a much smaller study, the prognosis for younger patients living with total hip replacements was positive, with researchers concluding that “today, among the patients still living… 46% of the original hip implants were still in place and functioning. In addition, many of the patients who died in the interim did so with their original implant in place. Overall, 63% of the original hip replacements were functioning at the latest follow-up or at the time of death.”

Risk of revision hip surgery study conclusions

Despite being just a small cohort of 69 patients, these patients were the perfect demographic to complement the bigger research conducted in the Netherlands. This research was conducted with data of patients who had a total hip replacement when they were aged between 18 and 49 years old. Researchers then checked in at regular intervals with the patients to see how they were getting on.

Ultimately, a total hip replacement in a younger patient has a tougher job to do – the patient will likely live longer and put more stresses and strains on the new joint compared with a much older patient. This said, the results of these recent studies are encouraging, suggesting advancements in technology, surgical skill and knowledge are all helping increase the longevity of total hip replacements in younger patients.

To discuss the potential risk of revision surgery, choose an expert. Call o20 8947 9524 to book a consultation with leading London hip specialist.