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Disparities in Elective and Nonelective Total Hip Arthroplasty
Gregory A Benes1, Vinod Dasa2, Peter C Krause2
1Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
The Journal of Arthroplasty
|January 23, 2023
Summary
Nonelective total hip arthroplasty (THA) is linked to patient factors like alcohol dependence and increased age. Modifiable risks such as tobacco and alcohol use increase revision surgery risk.
Area of Science:
- Orthopedics
- Arthroplasty Surgery
- Health Services Research
Background:
- Disparities in primary and revision total hip arthroplasty (THA) utilization are known.
- Limited data exists on patient population differences between elective and nonelective THA.
Purpose of the Study:
- To explore factors influencing primary THA utilization.
- To identify factors associated with revision THA risk based on surgery indication (elective vs. nonelective).
Main Methods:
- Retrospective analysis of 7,543 primary THA cases from 2014-2020.
- Classification of THA as elective (hip osteoarthritis) or nonelective (femoral neck fracture).
- Multivariable logistic regression to identify influencing factors and revision risk predictors.
Main Results:
- Nonelective THA associated with alcohol dependence, lower BMI, female sex, older age, and more comorbidities.
- No racial/ethnic disparities observed in primary THA utilization.
- Nonelective etiology increased odds of revision within 3 years (OR=1.66).
- Tobacco use (aOR=1.36), alcohol dependence (aOR=2.46), and public insurance (OR=2.08) increased reoperation risk.
Conclusions:
- Demographic and social factors significantly impact THA utilization and revision risk.
- Preoperative counseling for tobacco and alcohol cessation is crucial for reducing reoperation rates.
