Final solution in femoroacetabular impingement - Threaded cups in hip revision surgery 2002-2012

Abstract

Purpose: Here, we report the complications of endoprosthesis with threaded cups according to our application in cases of complicated acetabulum (hip revisions and femoroacetabular impingement (FAI)). Methods: A total of 504 patients was analyzed, including 189 men and 315 women. For re-implanted patients (n = 49), the mean time to re-implantation was 6.3 years and the average age at re-implantation was 54.7 years. For censored patients (n = 455), the mean time to censoring was 5.5 years and the average age of the implant was 55.7 years. Among the patients that were censored, 77 died and 378 patients did not experience an event necessitating re-implantation. Results: For the total study population, the Kaplan-Meier estimate of 5 year survival is 0.94 and of 10 year survival is 0.85. 90% of the implants survived 7 years, 80% of the implants survived almost 12 years and 70% of implants survived almost 15 years. Kaplan-Meier survival analysis suggests that men have higher survival than women. Age of the patient at the time of implant was not a statistically signifi cant factor for re-implantation (p value = 0.21) but sex was (p value = 0.02). Women had 2.25 times more risk of being re-implanted than men. Conclusions: In our case series, the failure rate, as a result of aseptic loosening, was 7.4% (n = 51). More than half the failure cases (56%) required re-implantation. Over one-third (37%) of the primary arthrosis cases, were found to be FAI, lessening the frequency of diagnosis of the former. In our clinic, the threaded cup seems to be indispensable in hip revision surgery and in treating FAI.