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Surgeons Often Are Blamed When Hip Replacements Fail
Date:1/3/2009

ounger age, and new and improved technology and techniques."

To assess the leading causes of hip-replacement failure, the study authors analyzed a nationwide hospital survey conducted between October 2005 and December 2006. The survey included data on all hip-replacement surgery revisions that were performed after initial hip-surgery failure.

Because the data was the first to be collected under a newly implemented and more detailed diagnostic and procedural coding system for hip replacements, Bozic and his colleagues were better equipped than previous researchers to identify apparent failure trends.

The survey identified more than 51,000 hip-revision surgeries.

Bozic and his colleagues found that the most common cause for the most common type of hip-revision surgery -- known as "total hip arthroplasty" -- was instability or dislocation of the initial hip device, which accounted for approximately 23 percent of cases. "Mechanical loosening" of the device caused nearly 20 percent of the revisions, and another 15 percent was attributed to infection.

"So the message is simple," Bozic said. "We found that there are causes of hip-replacement failure that we hadn't believed were the most common causes but that we now know are significant concerns and should be investigated further."

Dr. Jay Mabrey, chief of orthopedic surgery at Baylor University Medical Center in Dallas, was very enthusiastic about Bozic's study.

"Bozic is a kind of orthopedic genius, and this is a fantastic study," Mabrey said. "It's about time that someone went about proving that technique is more important than the prosthesis itself. It's something that those of us who do a lot of hip and knee replacements have known for quite a while. But no one's ever done anything like this before."

The bottom line, Mabrey said, is that "as a consumer you really should be concerned more with the surgeon who is going to put in the replace
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