The frequency of primary total hip arthroplasty procedures is increasing, with a subsequent rise in revision procedures. This study aims to describe timing and surgical mortality associated with revision total hip arthroplasty (THA) compared to those on the waiting list.
Methods:
All patients from a single institution who underwent revision total hip arthroplasty or were added to the waiting list for the same procedure between 2003 and 2013 were recorded. Mortality rates were calculated at 30 and 90 days following surgery or addition to the waiting list.
Results:
561 patients were available for the survivorship analysis in the surgical group. Following exclusion, 901 and 484 patients were available for the 30 and the 90-day analysis in the revision THA waiting list group.
30- and 90-day mortality rates were significantly greater for the revision THA group compared to the waiting list group (excess surgical mortality at 30 days = 0.357%, p = 0.037; odds ratio of 5.22, excess surgical mortality at 90 days = 0.863%, p = 0.045).
Conclusions:
Revision total hip arthroplasty is associated with a significant excess surgical mortality rate until 90 days post-operation when compared to the waiting list population. We would encourage other authors with access to larger samples to use our method to quantify excess mortality after both primary and revision arthroplasty procedures.
DaigleMEWeinsteinAMKatzJNLosinaE.The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol. 2012; 26(5): 649–658.
2.
EthgenOBruyèreORichyFDardennesCReginsterJY.Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004; 86-A(5): 963–974.
3.
ChangRWPellisierJMHazenGB.A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. JAMA. 1996; 275(11): 858–865.
4.
NJR Steering Committee. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man: 13th Annual Report. Hemel Hempstead; 2016: 1–182. -Available at: njrcentre.org.uk. Accessed July 10, 2017
5.
KurtzSMowatFOngKChanNLauEHalpernM.Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005; 87(7):1487–1497.
6.
RaviBCroxfordRReichmannWMLosinaEKatzJNHawkerGA.The changing demographics of total joint arthroplasty recipients in the United States and Ontario from 2001 to 2007. Best Pract Res Clin Rheumatol. 2012; 26(5): 637–647.
7.
SinghJAVesselyMBHarmsenWSet al. A population-based study of trends in the use of total hip and total knee arthroplasty, 19692008. Mayo Clin Proc. 2010; 85(10): 898–904.
8.
BozicKJKamathAFOngKet al. Comparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA. Clin Orthop Relat Res. 2015; 473(6): 2131–2138.
9.
BourneRBMaloneyWJWrightJG.An AOA critical issue. The outcome of the outcomes movement. J Bone Joint Surg Am. 2004; 86(3): 633–640.
10.
OngKLLauESuggsJKurtzSMManleyMT.Risk of subsequent revision after primary and revision total joint arthroplasty. Clin Orthop Relat Res. 2010; 468(11): 3070–3076.
11.
KurtzSOngKLauEMowatFHalpernM.Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007; 89(4): 780–785.
12.
MahomedNNBarrettJAKatzJNet al. Rates and outcomes of primary and revision total hip replacement in the -United States Medicare population. J Bone Joint Surg Am2003; 85(1): 27–32.
13.
FehringTKOdumSMFehringKSpringerBDGriffinWLDennosAC.Mortality following revision joint arthroplasty: is age a factor?Orthopedics. 2010; 33(10): 715.
14.
Lindberg-LarsenMJørgensenCCHansenTBSolgaardSKehletH.Early morbidity after aseptic revision hip arthroplasty in Denmark: a two-year nationwide study. Bone Joint J. 2014; 96-B(11): 1464–1471.
15.
RoussosCLübbekeAKoehnleinWHoffmeyerP.Outcomes of revision total hip arthroplasty in patients 80 years or older. J Bone Joint Surg Br. 2012;94(SUPP XXXVII):202.
16.
LieSAEngesaeterLBHavelinLIGjessingHKVollsetSE.Mortality after total hip replacement: 010-year follow-up of 39,543 patients in the Norwegian Arthroplasty Register. Acta Orthop Scand. 2000; 71(1): 19–27.
17.
BarrettJLosinaEBaronJAMahomedNNWrightJKatzJN.Survival following total hip replacement. J Bone Joint Surg Am. 2005; 87(9): 1965–1971.
18.
PaavolainenPPukkalaEPulkkinenPVisuriT.Causes of death after total hip arthroplasty: a nationwide cohort study with 24,638 patients. J Arthroplasty. 2002; 17(3): 274–281.
19.
WhittleJSteinbergEPAndersonGFHerbertRHochbergMC.Mortality after elective total hip arthroplasty in elderly Americans. Age, gender, and indication for surgery predict survival. Clin Orthop Relat Res. 1993; (295): 119–126.
20.
JonesMDParryMCWhitehouseMRBlomAW.Early death following primary total hip arthroplasty. J Arthroplasty. 2014; 29(8): 1625–1628.
21.
ParryMCSmithAJBlomAW.Early death following primary total knee arthroplasty. J Bone Joint Surg Am. 2011; 93(10): 948–953.
22.
HuntLPBen-ShlomoYClarkEMet al. National Joint Registry for England, Wales and Northern Ireland. 90-day mortality after 409,096 total hip replacements for osteoarthritis, from the National Joint Registry for England and Wales: a retrospective analysis. Lancet. 2013; 382(9898): 1097–1104.
23.
WilsonEB.Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927; 22(158): 209–212.
24.
BlomAPattisonGWhitehouseSTaylorABannisterG.Early death following primary total hip arthroplasty: 1,727 procedures with mechanical thrombo-prophylaxis. Acta Orthop. 2006; 77(3): 347–350.
25.
MantillaCBHorlockerTTSchroederDRBerryDJBrownDLBrownDL.Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology. 2002; 96(5): 1140–1146.
26.
HuntLPBen-ShlomoYWhitehouseMRPorterMLBlomAW.The main cause of death following primary total hip and knee replacement for osteoarthritis: a cohort study of 26,766 deaths following 332,734 hip replacements and 29,802 deaths following 384,291 knee replacements. J Bone Joint Surg Am. 2017; 99(7): 565–575.
27.
HowieCHughesHWattsAC.Venous thromboembolism associated with hip and knee replacement over a ten-year period: a population-based study. J Bone Joint Surg Br. 2005; 87(12): 1675–1680.
28.
PhillipsCBBarrettJALosinaEet al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am. 2003; 85(1): 20–26.
29.
PedersenABBaronJAOvergaardSJohnsenSP.Short- and long-term mortality following primary total hip replacement for osteoarthritis: a Danish nationwide epidemiological study. J Bone Joint Surg Br. 2011; 93(2): 172–177.
ChoiHRBeecherBBedairH.Mortality after septic versus aseptic revision total hip arthroplasty: a matched-cohort study. J Arthroplasty. 2013; 28(8)(Suppl): 56–58.
