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Mortality After Revision Total Hip Arthroplasty.

Mitzi S Laughlin1, Emily A Vidal1, Arin A Drtil2

  • 1Fondren Orthopedic Research Institute (FORI), Houston, TX.

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|February 9, 2021
PubMed
Summary

The 2-year mortality rate after revision total hip arthroplasty (revTHA) is 19.5 per 1000. Patients with periprosthetic fractures face a significantly higher mortality risk, emphasizing the need to discuss these risks during patient counseling.

Keywords:
dislocationinstabilitymortality rateperiprosthetic fracturerevision hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Patient Outcomes

Background:

  • Complications of revision total hip arthroplasty (revTHA) require careful patient counseling.
  • Mortality rates associated with revTHA are not well-defined by indication.
  • Determining revTHA mortality rates is crucial for informed patient consent.

Purpose of the Study:

  • To determine the overall mortality rate following revision total hip arthroplasty.
  • To identify specific mortality rates for revTHA based on the indication for revision.

Main Methods:

  • A retrospective review of 596 patients undergoing revTHA between 2012 and 2018.
  • Mortality status was ascertained through medical records and death indexes.
  • Survival analysis was performed using the last clinical visit date for censoring.

Main Results:

  • The overall 2-year mortality rate after revTHA was 19.5 deaths per 1000 (1 in 51).
  • Patients with periprosthetic fractures had a significantly higher 2-year mortality rate of 74.5 per 1000 (1 in 13).
  • Dislocation/instability showed a trend towards higher mortality (50.3 per 1000), but not statistically significant.

Conclusions:

  • Overall revTHA mortality is largely driven by periprosthetic fractures.
  • Indications like mechanical loosening or infection did not significantly alter mortality rates.
  • Mortality data, stratified by indication, is essential for pre-operative patient counseling.