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Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised.

Publication ,  Journal Article
Hinton, ZW; Wu, CJ; Ryan, SP; Cunningham, DJ; Green, CL; Lachiewicz, PF
Published in: J Arthroplasty
July 2022

BACKGROUND: The materials and techniques for both primary and revision total hip arthroplasty (THA) have changed over time. This study evaluated if the indications for revision THA, rates of components utilized (femoral or acetabulum, both, or head/liner exchange), length of stay (LOS), and payments to surgeons and facilities have also changed. METHODS: A retrospective study, utilizing the PearlDiver database, of 38,377 revision THA patients from January 2010 through December 2018 was performed. Data included the indication for revision, components revised (femoral or acetabulum, both, or head/liner exchange), LOS, and payments. Indications and components were analyzed by logistic regression (Dunnett's post hoc test). Revision totals were analyzed with a linear regression model. Analysis of variance assessed changes in LOS and payments. RESULTS: Patients' median age was 67 years (Q1-Q3: 59-74), and 58.7% were female. Revisions for dislocation decreased between 2010 and 2018 (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.68-0.98). Revisions for component loosening increased (OR 1.54, 95% CI 1.25-1.91). Dislocation remained the most common indication (19.3%), followed by PJI (17.3%) and loosening (17.1%). Both-component (OR:1.45; 95% CI:1.25-1.67) and femoral component only revisions increased; acetabular component only and head/liner exchanges decreased. Acetabular (OR 0.57, 95% CI 0.47-0.70) and head/liner exchange (OR 0.29, 95% CI 0.20-0.43) revisions decreased, while both component exchange (OR 1.45, 95% CI 1.25-1.67) and femoral revisions (OR 1.17, 95% CI 0.99-1.37) increased. Average LOS (-0.68 days; P < .001) and surgeon payments decreased (-$261.8; P < .001) while facility payments increased ($4,211; P < .001). CONCLUSION: Indications for revision THA in this database study changed over time, with revision for dislocation decreasing and revision for loosening increasing over time. Both component and femoral revisions increased, and acetabular component and head/liner exchanges decreased. It is possible that these associations could be attributed to a number of details, the method of femoral fixation, surgical approach, and cementing, all of which require additional study.

Duke Scholars

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

July 2022

Volume

37

Issue

7S

Start / End Page

S611 / S615.e7

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Reoperation
  • Prosthesis Failure
  • Prosthesis Design
  • Orthopedics
  • Male
  • Humans
  • Hip Prosthesis
  • Female
  • Arthroplasty, Replacement, Hip
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hinton, Z. W., Wu, C. J., Ryan, S. P., Cunningham, D. J., Green, C. L., & Lachiewicz, P. F. (2022). Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised. J Arthroplasty, 37(7S), S611-S615.e7. https://doi.org/10.1016/j.arth.2022.03.008
Hinton, Zoe W., Christine J. Wu, Sean P. Ryan, Daniel J. Cunningham, Cynthia L. Green, and Paul F. Lachiewicz. “Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised.J Arthroplasty 37, no. 7S (July 2022): S611-S615.e7. https://doi.org/10.1016/j.arth.2022.03.008.
Hinton ZW, Wu CJ, Ryan SP, Cunningham DJ, Green CL, Lachiewicz PF. Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised. J Arthroplasty. 2022 Jul;37(7S):S611-S615.e7.
Hinton, Zoe W., et al. “Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised.J Arthroplasty, vol. 37, no. 7S, July 2022, pp. S611-S615.e7. Pubmed, doi:10.1016/j.arth.2022.03.008.
Hinton ZW, Wu CJ, Ryan SP, Cunningham DJ, Green CL, Lachiewicz PF. Current Trends in Revision Hip Arthroplasty: Indications and Types of Components Revised. J Arthroplasty. 2022 Jul;37(7S):S611-S615.e7.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

July 2022

Volume

37

Issue

7S

Start / End Page

S611 / S615.e7

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Reoperation
  • Prosthesis Failure
  • Prosthesis Design
  • Orthopedics
  • Male
  • Humans
  • Hip Prosthesis
  • Female
  • Arthroplasty, Replacement, Hip