Patient mortality after total hip arthroplasty revision surgery

Complications following revision total hip arthroplasty can cause significant morbidity and have a high mortality rate. Patient age and American Society of Anaesthesiologists (ASA) physical status classification system score are important determinants of mortality following revision hip arthroplasty. There is a paucity of high-quality evidence assessing the risk of mortality following revision hip arthroplasty stratified by indications of surgery. The aim of this study is to compare survival of patients undergoing revision THA for different indications.

This retrospective case series reviewed the mortality rate following revision hip surgery performed by a single surgeon between 2009 and 2016 with a minimum 2 year follow up. Kaplan Meir analysis was performed using mortality as the end point. Log rank testing was used to determine if the indication for surgery conferred a difference in survival.

One hundred and ninety-eight consecutive cases were done using a tapered modular uncemented stem in 183 patients and were followed up for a mean period of 51.8 months (range, 24-121). Sixty patients died (67 % survivorship) during the follow up period with a 5-year survival rate of 78 %. Revision surgery performed for aseptic loosening had the best survival and hemiarthroplasty had the worst and differences in survival were statistically significant (P = 0.000002).

The indication for revision surgery is an important criterion which must be given weightage along with age, functional status of patient and ASA physical status score while planning revision surgery and counselling patients.