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Open Access Research article

Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis

Barbara Bordini1*, Susanna Stea1, Manuela De Clerico1, Sergio Strazzari2, Antonio Sasdelli3 and Aldo Toni14

Author Affiliations

1 Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli Via Barbiano 1/10, 40136 Bologna, Italy

2 Servizio di Farmacia, Istituti Ortopedici Rizzoli Via Barbiano 1/10, 40136 Bologna, Italy

3 Direzione Amministrativa, Istituti Ortopedici Rizzoli Via Barbiano 1/10, 40136 Bologna, Italy

4 I Divisione di Ortopedia e Traumatologia, Istituti Ortopedici Rizzoli Via Barbiano 1/10, 40136 Bologna, Italy

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BMC Musculoskeletal Disorders 2007, 8:69  doi:10.1186/1471-2474-8-69

Published: 24 July 2007

Abstract

Background

Total hip arthroplasty is a successful surgery, that fails at a rate of approximately 10% at ten years from surgery. Causes for failure are mainly aseptic loosening of one or both components partially due to wear of articular surfaces and partially to design. The present analysis aimed to identify risk factors and quantify their effects on aseptic failure.

Methods

Multivariate survival analysis was applied to 4,750 primary total hip arthroplasties performed between 1995 and 2000.

Results

The survival of the prosthesis is affected by gender, age, pathology, type of the prosthesis and skill of the. The worst conditions are male patients, younger than 40 years, affected by sequelae of congenital diseases, operated by a who performed less than 400 total hip artroplasty in the period. Furthermore, cemented cups and stems (less expensive) have a higher risk of failure compared with uncemented ones (more expensive).

Conclusion

The only variable that affects survival and that can be modified by is the type of prosthesis: a lower cost is associated to a higher risk. Results concerning the risk associated with cemented components are partially in disagreement with studies performed in countries where cemented prostheses are used more often than uncemented ones.