Related Experiment Video
Updated: May 13, 2025
The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
Evolving Patterns in Revision Total Hip Arthroplasty: Frequency, Complexity, and Indications Over Two Decades at a
Logan E Radtke1, Joshua P Rainey1, Nathan F Behrens1
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
Background:
Patterns in revision total hip arthroplasty (THA) have continued to evolve throughout the decades. We investigated whether these trends could vary by practice location and analyzed the indications and incidence of revision and "complex" revision THA at our isolated regional academic referral center over the past two decades. We hypothesized that our regional referral center has attracted an increasing level of complexity in revision THA cases over time.
Methods:
A retrospective chart review was conducted on all revision THAs from 2000 to 2023. Indications and details of revision THA were recorded. Using previously published methods, cases were classified as "complex" if they included extended trochanteric osteotomy, triflange, augments, or a cup-cage construct. Trends in indications and complexity were compared between the periods 2000 to 2004 (early) and 2019 to 2023 (recent) using Chi-square tests.
Results:
A total of 2,793 revision THAs were performed from 2000 to 2023 (an average of 116 revisions/year). Comparing 2000 to 2004 with 2019 to 2023, the average annual number of revision THA increased from 89.8 to 157.6. The total volume of complex revisions was higher (average 13.2 cases/year historically versus 20.2 recently). Specifically, the annual averages of extended trochanteric osteotomy increased from 6.8 to 9, augments from 0.8 to 4.2, triflange from 2.2 to 2.8, and cup-cage constructs from 5.4 to 5.8. Indications changed significantly over time, with more often loosening historically (39%) and infection or reimplantation more recently (35.9%) (P < 0.0001).
Conclusions:
At a large regional academic referral center, we have seen a major increase in the total number of revision THA cases with a concomitant increase in "complex" cases from 2000 to 2023. Indications for revision THA have transitioned from loosening historically to infection or reimplantation more recently.
