Patient-related risk factors for early revision of total hip replacements - A population register-based case-control study of 674 revised hips

In this population register-based, matched case-control study, we assessed patient-related factors and early risk of revision after total hip replacement (THR). Information was obtained via a mail survey among patients reported to the Norwegian Arthroplasty Register during the period 1987-1993. The study included 674 revised hips, as cases, and 1,343 hips with a primary operation only, as controls. Completed questionnaires were received from 81% of the 2,017 individual cases and controls. We identified a set of patient-related factors associated with poor THR prognosis. Increasing weight was a risk factor among male patients older than 67 years who were more than 1.77 m tall (p = 0.01). Smoking had no overall effect, but former heavy smokers had an increased risk of 2.6 compared to never-smokers. Alcohol intake was associated with an increased risk of dislocation. Revision due to infection was commoner among patients taking antidiabetic drugs (OR = 14) than among patients taking no medication. An increased overall revision risk was found among patients using systemic steroids (OR = 2.8) or local pulmonary steroids (OR = 6.0). The risk also increased in male patients performing regular exercise before the primary operation (OR = 2.6), and in female patients of working-age doing heavy work (OR=1.9).