Registry Data Show Complication Rates and Cost in Revision Hip Arthroplasty.

Area of Science:

• Orthopedic Surgery
• Health Economics
• Infectious Disease in Arthroplasty

Background:

• Revision total hip arthroplasty (rTHA) presents unique challenges compared to primary THA.
• Outcomes and costs associated with rTHA are less predictable.
• rTHA imposes a significant burden on patients, surgeons, and healthcare systems.

Purpose of the Study:

• To define indications and treatments for rTHA.
• To quantify readmission risks associated with rTHA.
• To evaluate the economic impact of rTHA within a hospital system.

Main Methods:

• Retrospective cohort study of 793 rTHA procedures across 27 hospitals (2017-2019).
• Chart reviews to classify indications and procedures.
• Collection of demographic, length of stay, discharge, readmission, and direct cost data.

Main Results:

• Infection was the indication for 46.3% of rTHA; septic cases had higher repeat rTHA likelihood (5.6x) and longer LOS (4.3 vs. 2.4 days).
• Direct costs varied significantly by revision type (two-stage exchange: $37,642; liner revision: $8,979) and infection status (septic: $17,696; aseptic: $11,204).
• The 90-day readmission rate was 21.8%, with septic revisions showing higher rates (13.5% vs. 8.3%).

Conclusions:

• Hip revisions, particularly for infection, carry increased risks and substantial economic implications for healthcare systems.
• Data can inform patient counseling regarding rTHA risks.
• Findings support advocacy for improved reimbursement for revision arthroplasty care.