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Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms

A NATIONWIDE DANISH FOLLOW-UP STUDY INCLUDING 36 984 PATIENTS

¹ Department of Clinical Epidemiology
² Department of Orthopaedic Surgery, Aarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, Denmark.
³ Department of Orthopaedic Surgery, Odense University Hospital, Sdr. Boulevard 30, 5000 Odense, Denmark.
⁴ Department of Orthopaedic Surgery, Aarhus University Hospital, Ole Worms Alle 1150, 8000 Aarhus C, Denmark.

Correspondence should be sent to Dr A. B. Pedersen; e-mail:abp{at}dce.au.dk

We examined the association between patient-related factors and the risk of initial, short- and long-term implant failure after primary total hip replacement. We used data from the Danish Hip Arthroplasty Registry between 1 January 1995 and 31 December 2002, which gave us a total of 36 984 patients. Separate analyses were carried out for three follow-up periods: 0 to 30 days, 31 days to six months (short term), and six months to 8.6 years after primary total hip replacement (long term). The outcome measure was defined as time to failure, which included re-operation with open surgery for any reason.

Male gender and a high Charlson co-morbidity index score were strongly predictive for failure, irrespective of the period of follow-up. Age and diagnosis at primary total hip replacement were identified as time-dependent predictive factors of failure. During the first 30 days after primary total hip replacement, an age of 80 years or more and hip replacement undertaken as a sequela of trauma, for avascular necrosis or paediatric conditions, were associated with an increased risk of failure. However, during six months to 8.6 years after surgery, being less than 60 years old was associated with an increased risk of failure, whereas none of the diagnoses for primary total hip replacement appeared to be independent predictors.

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