Kompendium 2020 Forschung & Klinik

TOP-Studien
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nerve lesions (1 N. femoralis, 1 N. peronaeus, 3 unspecified). The average
acetabular component inclination angle was 42° (±7.3; range 21°-63°).
Twelve hips (16%) showed an acetabular roof plasty, its presence had no
significant influence on the probability of revision surgery (p = 0.3368). Four
hips (5%) showed radiolucent lines around the acetabular component, but
none of them had revision surgery so far. In eight hips (11%) radiolucency
was detected around the stem, two (25%) of them were in the group of patients
who had already undergone revision surgery (one due to loosening of the stem,
the other due to polyethylene wear).
Discussion and Conclusion
We found a revision rate of 12% for THA after CPO at an average follow up of
12.7 years (±7.4; range, 2 weeks-36.9 years). The revision rate of 12% could
be partly owed to the long follow up interval, as complications probably had
time to develop, be detected, and addressed. Secondly, 62% of all conversion
THAs were performed prior to the year 2000 and may have resulted in higher
revision rates as older polyethylene components were used. However, the
revision rate compares to other studies in the literature seems to be at the
lower end.
Regarding the overall survival rate, we found out, that conversion THAs after
CPO (10-year OS 93%) would show a similar 10-year survival rate to primary
THA due to osteoarthritis, as reported in the Swedish (95,8%), US (95.2%)
and Australian (93.5%) registries. We could also show that our 10- and 20-
year survival rates (93% and 76%, respectively) were superior to the ones of
patients younger than 35 years with primary THA for osteoarthritis (87% and
61%, respectively) or untreated DDH (87% and 55%) 10,11 . This retrospective
study supports the hypothesis that prior CPO does not compromise the
prerequisites for successful conversion THA at a later stage.
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Author:
Eleonora Schneider is currently
completing her residency at the
Department of Orthopaedics and
Trauma Surgery at the Medical
University of Vienna. The main
focus of her research lies on
joint preserving techniques (hip
and knee).
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