Loosened hip joint prosthesis-decision options

Abstract

For the period 2013-2015, 36 patients underwent revision surgery because of secondary developed complications after primary hip joint replacement surgery. 14 of them were male and 23 – female, with average age 73 years. We examined 4 groups of patients depends on the complications type: - Aseptic loosening in 23 patients, appeared 10 years’ average following primary hip prosthesis surgery. - Septic loosening in 2 patients revealed on second to the tenth month post operatively. In two other patients we observed infected hematoma. - Hip joint prosthesis (luxation) because of trauma or extremely wrong motion we notice in 5 patients. In one of them we revealed acetabular cup malposition. - Periprosthetic fractures with aseptic loosening in 3 patients. All 36 patients had primary cemented hip joint prosthesis. In the first group depends on which prosthesis parts were loosened we did acetabular cup and femoral stem replacement in 15 patients, only acetabular cup replacement in 4 patients and in 3 patients only femoral stem replacement. In 2 patients from second group we replaced the primary prosthesis by total spacer for 8 months followed by revision prosthesis surgery. In 2 haematoma patients we performed debridement, lavage-drainage and long term antibiotic treatment. In 2 patients of third group we replaced the primary head with a longer one and in 3 other patients we replaced the primary acetabular cup by shoulder collar cemented cup. In 2 patients of fourth group we replaced the primary acetabular cup and femoral stem by shoulder collar cemented cup and by revisionary stem delivered by Implant and Zimmer (Revitan). In the third patient we implanted revisionary femoral stem (Implant). 3 years after revisionary hip joint prosthesis surgery we monitor good prosthesis stability and good functional scores