The key aspects of the study: 1) what has changed in the structure of revisions in recent years? 2) what is the spectrum of reasons for revision after primary hip arthroplasty and re-revision? 3) what are the demographic features of patients’ population undergoing the revision? Materials and methods. The authors conducted a retrospective evaluation of 2415 hip revision cases during the period of time from 2014 until 2018. Separately the authors assessed revisions after primary surgeries and re-revisions as well as the group of early revisions. Results. In the period from 2014 until 2018 the overall share of revisions was 16,6% from all total hip arthroplasties, at the same time the authors reported the absolute 1.7 times increase in number of revisions as well as increased share of revisions in the total structure of hip arthroplasty from 12,5% to 18,9% without significant variances in the number of primary procedures. The share of early revisions increased from 32.9% in 2013 to 56.7% while the number of early revisions amounted to 37.4% of all primary revisions. Gender composition in primary and revision hip arthroplasty varied insignificantly. Mean age at the moment of hip revision was 59.2% (95% CI from 58.7 to 59.7; Me 60 years) which is slightly less than in primary replacement — 60.2 years (95% CI from 58.9 to 61.1; Me 62 years), but such variances had a high statistical significance, р0.001. The main reasons for primary revisions were aseptic loosening of prosthesis components (50.3%), infection (27.6%), polyethylene wear and osteolysis (9.0%) as well as dislocations (6,2%). Re-revisions structure featured prevalence of infection (69.0%), aseptic loosening (20.8%) and dislocations (7,8%). Mean period of time after primary hip arthroplasty to revision was 7.9 years (95% CI from 7.7 to 8.2; Me 7.3), to first re-revision — 2.9 (95% CI from 2.6 to 3.2; Me 1.2), to second re-revision — 2.2 (95% CI from 1.8 to 2.7; Me 1.1), to third — 2,2 (95% CI from 1.7 to 2.8; Me 1.1), to fourth — 1.0 (95% CI from 0.6 to 1.3; Me 0.6), remaining cases demonstrated rather high heterogeneity. Conclusion. In the result of the present study the authors observed increased number of all revision hip arthroplasties, especially the share of early revisions within first five years from the moment of previous surgery. The most often reason for revision after primary hip arthroplasty was aseptic loosening of one or both components of prosthesis. Infection was the absolute leader in the group of re-revisions constituting over half of all reasons for secondary intervention.

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Introduction. The matter of the replacement of acetabular defects is becoming increasingly relevant today. In their clinic the authors used custom-made implants with trabecular coating for replacement of defects in the acetabulum where and when it was necessary to ensure extended fixation of the component. Purpose — to evaluate short-term clinical and functional outcomes, osteointegration of porous coated custom-made implants, the overall survival of structural components and to identify the causes of failures and complications. Materials and Methods. During the study the authors interviewed and evaluated radiographs of 48 patients operated from October 2015 to June 2018. The patients were interviewed before and after the surgery using the Oxford hip joint scale, quality of life EQ-5D and visual analogue pain scale. Radiographs were evaluated for a period of at least 12 months for the signs of osteointegration. Results. The average OHS scores increased from 14.9 (±7) to 37.6 (±7) (p<0.01). Quality of life according to the EQ-5D index increased from 0.2 (±0.2) to 0.7 (±0.2) (p<0.01). The average value by general health scales: before operations — 49 (±17) and 73 (±18) scores after surgeries (p<0.01). The average VAS pain score decreased from 73 (±10) to 19 (±19) points (p<0.01). Osteointegration was observed in 98 percent of cases. Migration of the implant with fracture of a flange was observed in one case. Conclusions. In the short-term follow up the use of custom-made implants significantly improves hip joint function and the patients’ life quality. Custom-made implants enable primary reliable fixation in case of complex acetabular defects. High rate of osteointegration is observed for custom-made implants with porous coating within at least 12 months. Longer follow-up is needed to evaluate long-term results.