Revision Total Hip Arthroplasty

Objectives. The overall rate of primary total hip arthroplasties done each year is increasing worldwide. The main reason for primary surgery is osteoarthritis – it was the diagnosis at the time of surgery for approximately 79% of the patients undergoing primary hip arthroplasty (AAOS Annual Report 2017). Annual numbers in the USA in 2017 was 277 200, in Latvia – 1082. The number of surgeries is growing, according to joint replacement registry data. As a result, increased numbers of revision arthroplasties between 2012 and 2016, data were collected on N = 36 091 revision hip arthroplasties compared with data from Latvia 2012–2017 was N = 948. To determine the rates of total hip arthroplasties comparing data from most popular joint registries (AJRR 2017, Swedish JR 2016, NZ and Australian JR 2018). To analyze the data of revision hip arthroplasties performed in Traumatology and Orthopaedics Hospital, Riga since 1993. Define the best treatment algorithms for the management of aseptic and septic total hip arthroplasties complications.
Methods. The search of publications published as Annual Reports from respected joint registries, selection data from reports for most common revision hip arthroplasties reasons. To acquire equal data from the Department of statistics in Traumatology and Orthopaedics Hospital.
Results. The most common indications for revision hip arthroplasties are aseptic loosening, instability/dislocation infection, and wear and osteolysis (the last two which often co-exist and are interrelated), accounting together for 54% of revisions recorded (AJRR 2017). These data are common with Latvian registry data; from 2010–2014, overall revision count N = 631, 91.2% were aseptic-related complications, and only 8.87% were septic. Meanwhile, in the USA, septic complications were 7.7%. The time till primary total hip arthroplasty failure by the literature is from 1.8–20% in 10 year period of time (AJRR 2017, Swedish JR 2016, NZ and Australian JR 2018). In Traumatology and Orthopaedics Hospital, registry data shows 15.08% in 10 years.
Conclusions. Most recent data from joint registries suggested that in the near future, revision hip arthroplasties will increase up to 219% (AAOS Annual Report 2017). The last decade in Latvia shows a slower increase of revision hip arthroplasty surgeries. It’s important to respect treatment algorithms for revision hip arthroplasty complication treatment.