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Clinical Trial
. 2023 Feb;143(2):1061-1069.
doi: 10.1007/s00402-022-04353-0. Epub 2022 Jan 28.

Mechanical failure of total hip arthroplasties and associated risk factors

Henrik C Bäcker  1 , Chia H Wu  2 , Arne Kienzle  3 , Carsten Perka  3 , Clemens Gwinner  3
Affiliations
Clinical Trial

Mechanical failure of total hip arthroplasties and associated risk factors

Henrik C Bäcker et al. Arch Orthop Trauma Surg. 2023 Feb.

Abstract

Introduction: Mechanical failure of total hip arthroplasties is a rare but devastating complication. With increasing numbers in primary arthroplasty implantation, revision surgeries are indicated more often. Therefore, understanding the mechanism and the location of failure is essential in determining proper treatment. Aim of this study was to identify mechanical failures of all total hip arthroplasties performed in a major academic center as well as the associated risk factors such as BMI and sports.

Methods: A retrospective trial was conducted using our prospective arthroplasty database. Database was searched for all patients presenting with mechanical failures of total hip arthroplasty (THA) to the emergency department between 2011 and 2019. All medical charts and radiographs as well as surgical reports were analyzed to identify demographics, implant choice in addition to location of failure and subsequent treatment.

Results: In total, 13 patients suffering from mechanical total hip implant failure were found. The femoral neck (conus) was broken in four patients, the stem in five cases, one broken inlay, two cup failures and one conus dislocation. The mean BMI was 31.42 ± 5.29 kg/m2 including five patients who have obesity class II. In all cases, revision surgeries were indicated. No structural causes or underlying risk factors such as repeated physical load (i.e. in sports) were identified.

Conclusion: Implant failure does not seem to correlate with participation in sports or BMI. Catastrophic failure of implants is a technical challenge requiring special extraction instruments that can be difficult even for experienced surgeons. It should be noted that functional outcome is often worse for this group of patients after surgery than comparing against those revised for loosening.

Level of evidence: III, Retrospective Trial.

Keywords: Arthroplasty; Complication; Failure; Hip; Outcome; THA.

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Conflict of interest statement

The authors have no conflict of interest directly related to this work.

Figures

Fig. 1
Fig. 1
A Zimmer Alloclassic Zweymüller conus fracture, B after Stem exchange and replacement with a S&N SLR stem, C broken ESKA stem before and after THA exchange—Modular TMT cup and Zweymüller Revision stem D, E broken Zimmer Alloclassic cup and after Cup exchange (Zimmer TMT cup, F)
See this image and copyright information in PMC

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