Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013

Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this...

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Vydáno v:The Journal of arthroplasty Ročník 32; číslo 7; s. 2088 - 2092
Hlavní autoři: Gwam, Chukwuweike U., Mistry, Jaydev B., Mohamed, Nequesha S., Thomas, Melbin, Bigart, Kevin C., Mont, Michael A., Delanois, Ronald E.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.07.2017
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ISSN:0883-5403, 1532-8406, 1532-8406
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Abstract Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure. We queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed. Dislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24. Dislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.
AbstractList Abstract Background Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure. Methods We queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed. Results Dislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24. Conclusion Dislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.
Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure. We queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed. Dislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24. Dislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.
Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure.BACKGROUNDDespite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure.We queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed.METHODSWe queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed.Dislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24.RESULTSDislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24.Dislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.CONCLUSIONDislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.
Author Thomas, Melbin
Mohamed, Nequesha S.
Delanois, Ronald E.
Bigart, Kevin C.
Gwam, Chukwuweike U.
Mont, Michael A.
Mistry, Jaydev B.
Author_xml – sequence: 1
  givenname: Chukwuweike U.
  surname: Gwam
  fullname: Gwam, Chukwuweike U.
  organization: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
– sequence: 2
  givenname: Jaydev B.
  surname: Mistry
  fullname: Mistry, Jaydev B.
  organization: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
– sequence: 3
  givenname: Nequesha S.
  orcidid: 0000-0002-9597-0370
  surname: Mohamed
  fullname: Mohamed, Nequesha S.
  organization: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
– sequence: 4
  givenname: Melbin
  surname: Thomas
  fullname: Thomas, Melbin
  organization: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
– sequence: 5
  givenname: Kevin C.
  surname: Bigart
  fullname: Bigart, Kevin C.
  organization: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
– sequence: 6
  givenname: Michael A.
  surname: Mont
  fullname: Mont, Michael A.
  organization: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
– sequence: 7
  givenname: Ronald E.
  surname: Delanois
  fullname: Delanois, Ronald E.
  organization: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28336249$$D View this record in MEDLINE/PubMed
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Issue 7
Keywords total hip arthroplasty
epidemiology
National Inpatient Sample
arthroplasty failure
revision
Language English
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Snippet Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system....
Abstract Background Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the...
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pubmed
crossref
elsevier
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Enrichment Source
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StartPage 2088
SubjectTerms Aged
arthroplasty failure
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - economics
Arthroplasty, Replacement, Hip - statistics & numerical data
Databases, Factual
epidemiology
Female
Hip Prosthesis - adverse effects
Humans
Inpatients
Male
Middle Aged
National Inpatient Sample
Orthopedics
Prosthesis Failure
Reoperation - economics
Reoperation - statistics & numerical data
revision
total hip arthroplasty
United States
Title Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013
URI https://www.clinicalkey.com/#!/content/1-s2.0-S088354031730164X
https://www.clinicalkey.es/playcontent/1-s2.0-S088354031730164X
https://dx.doi.org/10.1016/j.arth.2017.02.046
https://www.ncbi.nlm.nih.gov/pubmed/28336249
https://www.proquest.com/docview/1881265354
Volume 32
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