• Gareth S Turnbull, Scott Chloe E H CEH Department of Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Cresce... more nt, Edinburgh, EH16 4SA, UK., Deborah J MacDonald, and Steffen J Breusch. less
• Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK. gareth.turnbull@strath.ac.uk.
• Arch Orthop Trauma Surg. 2019 Mar 1; 139 (3): 411-421.

BackgroundDemand for revision total hip arthroplasty (RTHA) continues to grow worldwide and is expected to more than double within the next 1-2 decades. The primary aim of this study was to examine return to function following revision THA in a UK population.Patients And MethodsWe assessed 118 patients (132 RTHAs, mean age 65 years SD 13, range 23-88) at a mean follow-up of 7.9 years (SD 4.4) postoperatively. Preoperative age, gender, BMI, social deprivation, operative indication, comorbidities, activity level (UCLA score) and Oxford Hip Scores (OHS) were recorded. Postoperative UCLA score, OHS, EQ-5D, satisfaction levels and performance in activities of daily living (ADLs) were obtained and univariate and multivariate analysis performed.ResultsMean UCLA activity score improved following RTHA (p < 0.001): UCLA activity score improved in 37% and was unchanged in 50%; 49% of patients engaged in at least moderate level activities (UCLA score ≥ 6). Patient BMI, gender, age and reason for revision did not influence levels of pain, stiffness or activity at follow-up. Preoperative UCLA activity scores (p < 0.001) independently predicted long-term UCLA scores. Independent predictors (p < 0.05) of poor hip-specific function (OHS) following revision included social deprivation, revision for periprosthetic fracture and lower preoperative OHS. Difficulties with ADLs were associated with increasing deprivation, ≥ 3 comorbidities, and revision for periprosthetic fracture or infection (p < 0.05). Overall, 79% of patients remained satisfied or very satisfied following revision THA. Following RTHA, 10% suffered a dislocation and 13% required reoperation for complications.ConclusionRevision THA facilitates long-term return to preoperative levels of physical activity in the majority of patients, though activity levels increase in one-third only. Overall over three-quarters are satisfied with their outcome, but revision for periprosthetic fracture or dislocation gives the worse overall outcomes and lower satisfaction levels.

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