However, this study reviewed revision operations from 1985 through 2000 and did not distinguish osteolysis around a well-fixed implant from osteolysis and loosening.

The modes of failure of femoral components were 71% from osteolysis or loosening, 11% from pain, 9% from dislocation, 5% from malposition, and 3% from infection. In 2001, Paprosky et al 17 reported on 270 consecutive revision arthroplasties, noting that the modes of failure of the acetabular components were 71% from osteolysis or loosening, 16% from dislocation, 6% from migration, 2.5% from pain, 2.5% from infection, and 2% from malposition. 2,9,10,16,20 Recent literature describing the indications for revision hip arthroplasty among a cohort of patients is limited.

Most reports on revision THA focus on outcome and implant performance after revision surgery. Similarly, the total number of hip arthroplasties per 1,000 medicare enrollees increased from 2.6 to almost 3 during the same time period 22. For example, in 1993, 16.8% of hip arthroplasties were revisions whereas in 1997, 17.3% of hip arthroplasties were revisions. 6,9,18 As the population ages and more total hip arthroplasties (THAs) are done, the number of revision hip surgeries is increasing. Although revision surgery can be quite effective, it is costly and associated with considerable potential morbidity. Although the clinical success rate at 10 years exceeds 90%, 1,3,4,5,8,11,12,15,19 late failure remains a problem that can result in revision surgery. Total hip replacement (THR) remains one of the most successful and cost-effective surgeries done.

Hip replacement revisions