Rerevision

Overall second revision
By procedure year of first major revision
By type of first revision
By time to first revision
By fixation of primary THA
Reasons for second revision by type of first revision

Hip » Survival » Rerevision » Overall second revision

FIGURE Cumulative second revision percentage of total hip arthroplasty after a one-stage first revision in the Netherlands in 2007-2022 (n=13,847)

TABLE Cumulative second revision percentages

	Number at risk (n)	Competing Risk (95% CI)	Kaplan Meier¹ (95% CI)
1-year second revision (%)	11,231	8.4 (8.0-8.9)	8.2 (7.8-8.7)
3-year second revision (%)	8,283	12.3 (11.7-12.8)	12.4 (11.9-13.0)
5-year second revision (%)	5,656	14.1 (13.5-14.7)	14.6 (14.0-15.3)
7-year second revision (%)	3,588	15.7 (15.0-16.4)	16.4 (15.7-17.1)
10-year second revision (%)	1,514	17.2 (16.4-18.0)	18.4 (17.5-19.2)

¹ The cumulative revision percentage using the Kaplan Meier method is shown in the figure.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
CI: confidence interval.

Hip » Survival » Rerevision » By procedure year of first major revision

FIGURE Cumulative second revision percentage of total hip arthroplasty after a one-stage first revision by procedure year of first major revision in the Netherlands in 2012-2022 (n=7,579)

TABLE Cumulative second revision percentages

		Cumulative second revision percentages – Kaplan Meier (95% CI)
Procedure year first major revision	Number (n)	1yr	3yr	5yr	7yr
2011-2012	1,097	4.30 (3.10-5.50)	8.61 (6.94-10.28)	10.79 (8.93-12.65)	12.17 (10.19-14.15)
2013-2014	1,309	5.08 (3.88-6.28)	9.91 (8.27-11.55)	12.15 (10.35-13.95)	13.66 (11.75-15.57)
2015-2016	1,537	6.06 (4.86-7.26)	9.73 (8.23-11.23)	11.45 (9.83-13.07)	13.32 (11.53-15.11)
2017-2018	1,812	5.41 (4.36-6.46)	9.44 (8.07-10.81)	11.35 (9.83-12.87)	n.a.
2019-2020	1,824	6.21 (5.09-7.33)	10.12 (8.69-11.55)	n.a.	n.a.

Please note: n.a. if <50 cases were at risk.
Major revision: revision of at least the acetabulum or femur component.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
CI: confidence interval.

Hip » Survival » Rerevision » By type of first revision

FIGURE Cumulative second revision percentage of total hip arthroplasty after a one-stage first revision by type of first revision in the Netherlands in 2007-2022 (n=13,847)

TABLE Cumulative second revision percentages

		Cumulative second revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr
Major first revision	10,350	5.8 (5.3-6.3)	9.9 (9.3-10.5)	11.9 (11.2-12.6)	13.7 (12.9-14.5)
Minor first revision	3,322	14.9 (13.7-16.1)	19.6 (18.2-21.0)	22.1 (20.5-23.6)	24.1 (22.4-25.8)

One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
Major revision: revision of at least the acetabulum or femur component.
Minor revision: only inlay and/or femoral head exchange (including DAIR procedures).
Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
CI: confidence interval.

Hip » Survival » Rerevision » By time to first revision

FIGURE Cumulative second revision percentage of total hip arthroplasty after a one-stage first revision by time to first revision in the Netherlands in 2007-2022 (n=13,847)

TABLE Cumulative second revision percentages

		Cumulative second revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr
First revision within 1 year	6,546	11.2 (10.4-12.0)	15.5 (14.6-16.4)	17.2 (16.2-18.1)	18.5 (17.4-19.5)
First revision within 1-3 years	2,865	5.3 (4.5-6.2)	10.4 (9.2-11.6)	13.7 (12.3-15.0)	16.2 (14.6-17.7)
First revision within 3-5 years	1,584	5.6 (4.5-6.8)	9.2 (7.7-10.7)	12.1 (10.3-13.9)	13.7 (11.7-15.7)

One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
CI: confidence interval.

Hip » Survival » Rerevision » By fixation of primary THA

FIGURE Cumulative second revision percentage of total hip arthroplasty after a one-stage first revision by fixation of the primary procedure in the Netherlands in 2007-2022 (n=13,546)

TABLE Cumulative second revision percentages

		Cumulative second revision percentages – Kaplan Meier (95% CI)
Fixation of primary THA	Number (n)	1yr	3yr	5yr	7yr
Uncemented	8,953	7.8 (7.3-8.4)	12.1 (11.4-12.8)	14.4 (13.6-15.2)	16.2 (15.3-17.1)
Cemented	3,080	9.5 (8.4-10.5)	13.5 (12.2-14.8)	15.5 (14.1-16.9)	16.8 (15.2-18.4)
Reversed hybrid	815	7.6 (5.7-9.4)	13.3 (10.8-15.8)	16.0 (13.2-18.8)	18.3 (15.1-21.6)
Hybrid	698	9.0 (6.8-11.2)	12.5 (9.9-15.1)	13.8 (11.0-16.7)	17.3 (13.6-21.0)

Hip » Survival » Rerevision » Reasons for second revision by type of first revision

TABLE Reasons for second revision within seven years in patients who underwent a second revision after a one-stage first revision of a total hip arthroplasty by type of first revision in the Netherlands in 2007-2022

	Major first revision¹ (n=1,116)	Minor first revision² (n=676)	Any type of first revision³ (n=1,858)
Reasons for second revision	Proportion⁴ (%)	Proportion⁴ (%)	Proportion⁴ (%)
Infection	30.6	59.6	41.6
Dislocation	26.7	26.5	26.1
Loosening of acetabulum component	19.8	5.0	14.0
Loosening of femur component	17.7	4.9	12.8
Peri-prosthetic fracture	10.2	2.7	7.3
Inlay wear	3.2	2.8	3.0
Symptomatic MoM bearing	1.5	0.4	1.1
Peri-articular ossification	1.0	0.3	0.7
Other	12.6	7.4	1.0

¹ Revision of at least the acetabulum or femur component.
² Only inlay and/or femoral head exchange (including DAIR procedures).
³ Any type of revision includes minor and major revisions as well as revision procedures that could not be classified as minor or major revision.
4 One patient may have more than one reason for revision or re-surgery. As such, the total proportion is over 100%.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.

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