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Early mortality after modern total hip arthroplasty
Michael Aynardi1, Luis Pulido, Javad Parvizi
1Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Clinical Orthopaedics and Related Research
|October 11, 2008
Summary
Mortality after total hip arthroplasty (THA) remains low, with 90-day rates at 0.55%. Cardiovascular issues were the leading cause of death in this study of uncemented THA patients.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Public Health
Background:
- Improvements in surgical techniques, anesthesia, and rehabilitation may reduce mortality rates following hip arthroplasty.
- Total hip arthroplasty (THA) is increasingly performed on a diverse patient population, including those with multiple comorbidities.
Purpose of the Study:
- To determine the 90-day mortality rate after uncemented total hip arthroplasty (THA) performed under regional anesthesia.
- To analyze the causes of death within 90 days of THA.
Main Methods:
- Retrospective review of 7478 consecutive patients undergoing cementless primary or revision THA between January 2000 and July 2006.
- Patient survivorship and causes of death were determined using national and state vital statistics databases.
- Level IV therapeutic study.
Main Results:
- The overall 30-day mortality rate was 0.24% (18/7478), and the 90-day mortality rate was 0.55% (41/7478).
- Thirty-day mortality for primary THA was 0.13% (8/6272).
- Cardiovascular-related events were the most common cause of death.
Conclusions:
- Mortality following modern total hip arthroplasty remains very low, even in elderly patients and those with comorbidities.
- Regional anesthesia and advancements in surgical and rehabilitation protocols contribute to favorable outcomes.