Outcome and risk factors of failures associated with revision total hip arthroplasty for recurrent dislocation

Klemt, Christian; Chen, Wenhao; Bounajem, Georges; Tirumala, Venkatsaiakhil; Xiong, Liang; Kwon, Young Min

doi:10.1007/s00402-021-03814-2

Cited by 11 publications

(8 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We investigated the postoperative cumulative incidence of dislocation after hip arthroplasty in 471 patients with MBD of the hip. Due to exclusion criteria, none of the patients had acetabular defects that required pelvic reconstruction or received surgery for a failed endoprosthesis, which are known risk factors for dislocation ( 11 , 12 ). We found a 1-year cumulative incidence of dislocation of 6.2% and a 5-year incidence of 6.8%.…”

Section: Discussionmentioning

confidence: 99%

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

Iljazi

Sørensen

Hovgaard

et al. 2023

ActaO

View full text Add to dashboard Cite

Background and purpose: Joint stability after hip replacement (HR) in patients with metastatic bone disease (MBD) is of special importance. Dislocation is the second leading cause of implant revision in HR, while survival after MBD surgery is poor with an expected 1-year survival of around 40%. As few studies have investigated the dislocation risk across different articulation solutions in MBD, we conducted a retrospective study on primary HR for patients with MBD treated in our department.Patients and methods: The primary outcome is the 1-year cumulative incidence of dislocation. We included patients with MBD who received HR at our department in 2003–2019. We excluded patients with partial pelvic reconstruction, total femoral replacement, and revision surgery. We assessed the incidence of dislocation with competing risk analysis with death and implant removal as competing risks.Results: We included 471 patients. Median follow-up was 6.5 months. The patients received 248 regular total hip arthroplasties (THAs), 117 hemiarthroplasties, 70 constrained liners, and 36 dual mobility liners. Major bone resection (MBR), defined as resection below the lesser trochanter, was performed in 63%. The overall 1-year cumulative incidence of dislocation was 6.2% (95% CI 4.0–8.3). Dislocation stratified by articulating surface was 6.9% (CI 3.7–10) for regular THA, 6.8% (CI 2.3–11) for hemiarthroplasty, 2.9% (CI 0.0–6.8) for constrained liner, and 5.6% (CI 0.0–13) for dual mobility liners. There was no significant difference between patients with and without MBR (p = 0.5).Conclusion: The 1-year cumulative incidence of dislocation is 6.2% in patients with MBD. Further studies are needed to determine any real benefits of specific articulations on the risk of postoperative dislocation in patients with MBD.

show abstract

Section: Discussionmentioning

confidence: 99%

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

Iljazi

Sørensen

Hovgaard

et al. 2023

ActaO

View full text Add to dashboard Cite

show abstract

“…Klemt C et al observed that osteoporosis was an independent risk factor for THA failure in patients with recurrent dislocation [33]. At the same time, diabetes increases bone absorption and bone loss, eventually leading to bone loss [34].…”

Section: Discussionmentioning

confidence: 99%

Can a Nomogram Predict the Failure Risk of Internal Fixation Devices in Chinese Patients Undergoing Hip Arthroplasty?

Huang¹,

Zeng

2023

Preprint

View full text Add to dashboard Cite

Background:In order to achieve more accurate and personalized patient risk assessments and further understand the superposition effect of multiple risk factors, it is imperative to develop and validate a nomogram for the risk of failure of hip arthroplasty in Chinese patients. Methods:Data from 1198 patients who underwent hip arthroplasty in the First Affiliated Hospital of Guangxi Medical University from February 2012 to January 2021 were collected. Then, 1014 cases were assigned to the normal group and 184 cases to the failure group. Patients were further divided into training and verification tests. The risk assessment of failure for hip arthroplasty comprised 18 variables. In the training test, LASSO regression was applied to optimize the characteristics of revision hip arthroplasty. Lastly, significant variables in the LASSO regression analysis were included in the multivariate logistic regression analysis. Results:The C index was 0.715 (95% confidence interval: 0.667-0.763), and the area under the curve (AUC) was 0.715. Decision curve analysis illustrated that the predictive value of the nomogram was high, and its net income was between 0.06 and 0.4 or 0.51 to 0.69. Moreover, the C index of the validation test was 0.680. The parameters in the risk nomogram included body mass index (BMI), collar or collarless femoral stem, sparse trabecular bone, presence or absence of screws and the number of screws, history of diabetes, and occupation. Conclusion: The model had a satisfactory predictive ability. The higher the score, the higher the probability of failure. This will aid doctors in assessing the risk of failure of patients undergoing hip arthroplasty prior to the intervention.

show abstract

“…However, the use of electronic medical records has seen a widespread use for clinical outcome research for patients with total hip and knee arthroplasty. 6,44,45 Finally, our study findings are limited to risk factors for early THA failure within 2 years after index THA. Therefore, it remains unclear whether the same or other risk factors are associated with long-term THA failure.…”

Section: Figurementioning

confidence: 91%

“…4 Even if the rate of early revision after primary THA remains stable over the next decade, as many as 60,000 US citizens are predicted to annually undergo early revision THA from 2030 onward. As revision THA represents a surgically more challenging procedure that is associated with increased morbidity and mortality, alongside significantly higher costs of care, 5,6 the preoperative identification of patients with an increased risk of early THA failure has the potential to reduce the future prevalence of revision THA.…”

mentioning

confidence: 99%

The Utility of Machine Learning Algorithms for the Prediction of Early Revision Surgery After Primary Total Hip Arthroplasty

Klemt

Laurencin

Alpaugh

et al. 2022

J Am Acad Orthop Surg

Self Cite

View full text Add to dashboard Cite

Background: Revision total hip arthroplasty (THA) is associated with increased morbidity, mortality, and healthcare costs due to a technically more demanding surgical procedure when compared with primary THA. Therefore, a better understanding of risk factors for early revision THA is essential to develop strategies for mitigating the risk of patients undergoing early revision. This study aimed to develop and validate novel machine learning (ML) models for the prediction of early revision after primary THA. Methods: A total of 7,397 consecutive patients who underwent primary THA were evaluated, including 566 patients (6.6%) with confirmed early revision THA (,2 years from index THA). Electronic patient records were manually reviewed to identify patient demographics, implant characteristics, and surgical variables that may be associated with early revision THA. Six ML algorithms were developed to predict early revision THA, and these models were assessed by discrimination, calibration, and decision curve analysis. Results: The strongest predictors for early revision after primary THA were Charlson Comorbidity Index, body mass index .35 kg/m 2 , and depression. The six ML models all achieved excellent performance across discrimination (area under the curve .0.80), calibration, and decision curve analysis. Conclusion: This study developed ML models for the prediction of early revision surgery for patients after primary THA. The study findings show excellent performance on discrimination, calibration, and decision curve analysis for all six candidate models, highlighting the potential of these models to assist in clinical practice patient-specific preoperative quantification of increased risk of early revision THA.T otal hip arthroplasty (THA) represents one of the most commonly performed procedures to treat patients with end-stage osteoarthritis to alleviate pain and restore joint functionality. 1 Recent literature demonstrated a significantly increasing demand for primary THA over the

show abstract

Outcome and risk factors of failures associated with revision total hip arthroplasty for recurrent dislocation

Cited by 11 publications

References 40 publications

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

Can a Nomogram Predict the Failure Risk of Internal Fixation Devices in Chinese Patients Undergoing Hip Arthroplasty?

The Utility of Machine Learning Algorithms for the Prediction of Early Revision Surgery After Primary Total Hip Arthroplasty

Contact Info

Product

Resources

About