Objective: This systematic review and meta-analysis aimed to estimate re-revision rates of retained femoral components after revision of total hip arthroplasty (THA).
Methods: Papers were searched in the PubMed, Embase, Web of Science, and Cochrane Library databases with predetermined keywords from January 2000 to January 2022. The studies reporting the re-revision rates of retained stems after revision THA were identified. Pooled rates of re-revision for any reason and aseptic loosening were calculated using a random-effects model or a fixed-effects model based on the results of heterogeneity assessment after the Freeman-Tukey double-arcsine transformation. A meta-regression was performed to explore potential sources of heterogeneity.
Results: There were 20 studies with 1,484 hips that received the isolated cup revision with the femoral component retained. The pooled re-revision rate of retained stems was 1.75% [95% confidence interval (CI) 0.43%-3.65%]. The re-revision rate of retained stems due to aseptic loosening was 0.62% (95% CI, 0.06%-1.55%). The meta-regression showed that the fixation type (cemented or cementless) was related to the re-revision rate for any reason and the re-revision rate for aseptic loosening.
Conclusion: Based on the existing evidence, the isolated cup revision with a stable stem in situ yields low re-revision rates. The cement status of retained stems may influence the survivorship of stems.
Keywords: meta-regression; re-revision rate; retained femoral component; revision total hip arthroplasty; systematic review and meta-analysis.
© 2022 Li, Zhuang, Wu, Gan, Wu, Peng, Huan and Liu.