Validity of same-side reoperation after total hip and knee arthroplasty using administrative databases

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Biostatistics

Background:

• Administrative databases are crucial for evaluating arthroplasty outcomes.
• Current coding systems (ICD-9, CPT) often omit laterality, complicating reoperation analysis.
• Accurate reoperation data is vital for assessing surgical success and patient safety.

Purpose of the Study:

• To determine the frequency of same-sided reoperations after total hip arthroplasty (THA) and total knee arthroplasty (TKA).
• To identify factors associated with ipsilateral reoperations following THA and TKA.
• To highlight potential misclassification in orthopedic research using administrative data.

Main Methods:

• Analysis of a hospital-based patient sample undergoing multiple THA or TKA.
• Comparison of the operative side for index procedures versus subsequent operations.
• Calculation of concordance (same-side reoperations) for THA and TKA.

Main Results:

• Overall concordance was 23% for THA and 22% for TKA.
• The majority of reoperations occurred on the contralateral (opposite) side.
• This suggests significant misclassification of reoperation laterality in administrative datasets.

Conclusions:

• Administrative data may inaccurately represent reoperation rates due to lack of laterality information.
• Researchers using these datasets should account for potential misclassification of ipsilateral reoperations.
• Future research should aim to improve data collection to accurately capture revision THA and TKA laterality.