Revision Total Hip Arthroplasty — What Are We to Expect?

The paper analyzes the local total hip arthroplasty (THA) registry database over 18 years, from 2007 to 2024. The following questions were posed. Are there any changes in the structure of revision THA? What are the current trends in revision THA in recent years? What revision technologies are being utilized? A total of 11.201 cases of revision procedures were analyzed, which accounted for 12.4% of all registered THAs. Compared to previous analyses, the share of early revisions has increased — 42.2% of initial revisions and 87.6% of subsequent re-revisions are performed within the first five years after the previous surgery. This analysis revealed several important trends: The significant increase in both the absolute number and proportion of infection-related revisions (40.7%). This share is significantly higher for re-revisions (72.5%) compared to 20.2% for initial revisions. Rejuvenation of revision — the average age is 60.7 years for aseptic revisions and 58.5 for infection-related ones. The increase in proportion of trabecular metal constructs and other revision acetabular components, as well as a significant increase (up to 11.9%) of custom-made acetabular implants produced via 3D printing. For femoral component revision, there is a steady trend towards using Wagner-type tapered fluted titanium components. Their share increased from 39.4% in 2019 to 61.7% in 2024. There is a sharp increase in the number of revision procedures, a growing proportion of complex revisions requiring advanced and costly implants, and an exceptionally rapid rise in the number of infection-related revisions. It is therefore clear that the challenges of revision arthroplasty may soon affect all surgeons performing primary total hip arthroplasty — initially through the need to manage infectious complications, and later due to the gradual accumulation of patients requiring other types of revisions, including repeat procedures.