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Prosthetic survival not affected by surgical technique, individual patient factors

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Gender, age, body mass index, activity level, surgical technique and cement use are not related to Harris Hip scores or implant loosening after total hip arthoplasty, according to a recent presentation at the SICOT XXV Triennial World Congress 2011.

In his study, Manouchehr Vahid Farahmandi, from the Akhtar Orthopaedic Hospital in Tehran, Iran, concluded that unneccesary delays in performing total hip arthroplasty (THA) caused limping and lower Harris Hip scores in patients who underwent the procedure. Defects in joint anatomy and weakness of the surrounding muscles were causes of these complications, according to the study abstract.

“The aim of this study is to assess the effect of these factors in our center within the past 20 years,” Farahmandi said during his presentation.

Using revision surgery as an endpoint, cemented prosthetic cups had a 60% survival rate and uncemented cups showed an 85% survival rate, the study noted. Using radiographic evidence of loosening as an endpoint yielded an 80% survival rate for cups; cemented stems had a 60% survival rate, while uncemented stems had a 70% rate. THA in the study showed a shorter survival rate than those reported in previous case studies, Farahmandi noted.

To determine whether a patient’s gender, body mass index, prosthetic type, lifestyle or daily activities had an impact on implant loosening, Farahmandi examined 210 patients with a mean age 65 years who had a total of 235 THAs and 49 revision arthoplasties between 1985 and 2005. The average follow-up was 6.1 years: 167 patients (79.52%) were followed either in person or by telephone. During the follow-up, 27 patients died and 17 were unable to be followed. Of these patients, there were 25 reports of trauma-related prosthetic dislocations, according to the abstract.

Reference:

• Farahmandi MV. The influence of demographic factors, surgical approaches and implant design on long-term outcome of total hip replacement. Paper #28661. Presented at the SICOT XXV Triennial World Congress 2011. Sept 6-9. Prague.

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