Fate of the Retained Acetabular Component During Revision Total Hip Arthroplasty: A Meta-Analysis and Systematic Review

BACKGROUND:

The aim of this meta-analysis and systematic review is to estimate re-revision rates due to aseptic loosening of retained acetabular components after revision total hip arthroplasty.

METHODS:

PubMed, EMBASE, Cochrane Library, and Web of Science were searched until June 11, 2018. Data were extracted by 2 independent investigators and consensus was reached with the involvement of a third investigator. Rates of re-revision due to aseptic loosening from 6 studies were aggregated using random effects model after a logit transformation and were grouped by study and population level characteristics.

RESULTS:

An assessment of the re-revision rates of retained acetabular components due to aseptic loosening in revision total hip arthroplasty was reported in 6 studies involving 669 cases. The pooled re-revision rate was 12.6% (95% confidence interval 8.4-18.4) with a mean study follow-up of 8.6 years. The rate of re-revision due to aseptic loosening of retained acetabular components was 6.8% (95% confidence interval 3.4-13.3). In the univariate meta-regression analysis, mean age at index revision surgery was significantly associated with the rate of re-revision due to aseptic loosening (R2 = 99.98%, P < .0001).

CONCLUSION:

Based on this exploratory analysis, revision hip procedures with retentions of well-fixed acetabular components generally have a low risk of failure during mid-term to long-term follow-ups.

 2019 Oct 4. pii: S0883-5403(19)30924-6. doi: 10.1016/j.arth.2019.09.041. [Epub ahead of print]