Aims

The aim of this study was to explore the relationship between reason for revision total hip arthroplasty (rTHA) and outcomes in terms of patient-reported outcome measures (PROMs).

We designed a study to evaluate whether (1) there were differences in PROMs between different reasons for revision THA at baseline, (2) there was a different interaction effect for revision THA for all PROMs, and (3) complication and re-revision rates differ between reason for revision THA.

Prospective cohort of 647 patients undergoing rTHA, with a minimum of 2 years FU. The reason for revision were classified as infection, aseptic loosening, dislocation, structural failure and painful THA with uncommon causes. PROMs (EQ-5D score, Oxford hip score (OHS), VAS pain, complication and failure rates were compared between different groups.

Patients with different reason for revision had improvement of PROMs’ over time. Preoperatively, patients revised due to infection and aseptic loosening had poorer OHS and EQ-5D than patients with other reason for revision. Pain scores at baseline were highest in patients revised due to dislocation. Infection and aseptic loosening groups also showed a significant interaction effect over time in both OHS and EQ-5D. No PROMs significant differences between groups were observed 2 years postoperatively. Overall complications, and re-revision rates were 35.4 and 9.7% respectively.

The reason for revision THA did not associate with clinical outcomes. Good outcomes were reached regardless of the reason for revision, as patients with the poorest pre-operative scores had the best improvement in PROMs over time. Complication and re-operation rates were relatively high, in line with previous reports, but did not differ between different reasons for revision THA.