New risk emerges for hip revision surgery

HIP prostheses with exchangeable femoral necks have emerged as another major risk factor for revision surgery, in an analysis triggered by concern over failing metal-on-metal joints.
The Australian Orthopaedic Association (AOA) has released data for knee and hip replacements in 2010, along with an examination of the spike in revisions linked to the now withdrawn DePuy hip prosthesis (MO, 17 May).
 “Even with metal-on-metal bearings, which have a higher rate of revision compared to other bearing surfaces, the use of exchangeable necks further increases the rate of revision,” the AOA annual report said.
“Femoral stems with exchangeable femoral necks have twice the rate of revision compared to all other femoral stems.”
The analysis also adds new detail to the high revision rate seen in people with metal-on-metal hips, with joints involving a head size greater than 32 mm emerging as the