UNDIAGNOSED HAEMOCHROMATOSIS – AN EXPLANATION FOR EARLY FAILURE OF HIP ARTHROPLASTY

Aseptic loosening of implants following hip arthroplasty is a cause of significant patient morbidity. We genotyped 99 revision hip arthroplasty patients and 116 primary hip arthroplasty patients for the C282Y and the H63D mutations, which cause Haemochromatosis. Haemochromatosis is an inherited condition leading to excessive iron absorption and deposition in the body. All patients at the time of their primary hip arthroplasty were diagnosed as having osteoarthritis. We identified 9 of the 99 revision arthroplasty patients as being homozygous for the C282Y mutation. The time to revision in this group was significantly lower (p< 0.005) when compared to the remaining 90 patients in the group (mean 8.7 years vs 14.8 years). Analysis of variables such as patient age and sex and also type of prosthesis, place of surgery and operating surgeon had no confounding influence. We hypothesise that undiagnosed iron overload in the patients homozygous for the C282Y mutation is likely to cause premature failure of their ...