Outcomes of Rivision of Total Hip Arthroplasty in Patients in Secondary Care Hospital
Abstract
Background: Although total hip arthroplasty is a popular surgery, little is known about its outcomes.
Aim of the study: The purpose of this study was to investigate the demographics and outcomes of patients receiving primary and revision total hip arthroplasty in terms of their impact on hospital and surgeon resource use and referral patterns to a secondary care hospital.
Methods: Clinical, demographic, and economic data were collected for forty-eight consecutive patients with an infection following a total hip replacement who underwent a two-stage revision arthroplasty (Group 1) performed by one of two surgeons between January 1, 2022 and December 1, 2024, at the Department of Orthopaedics & Traumatology, TMSS Medical College & Rafatullah Community Hospital (TMC & RCH), Bogura, Bangladesh, Uttara Adhunik Medical College and Hospital, Uttara, Dhaka., Bangladesh & Enam Medical College Hospital, Savar, Dhaka, Bangladesh. During the same time period, data were collected for a cohort of 48 patients who received revision of both components due to aseptic loosening (Group 2) and 48 patients who underwent primary hip arthroplasty (Group 3).
Results: Revisions for infection resulted in longer operational times, more blood loss, and more complications compared to revisions for aseptic loosening or original total hip arthroplasty (p < 0.02). Revisions for infection were linked to increased hospitalizations, days in the hospital, operations, costs, outpatient visits, and charges within a year of the index procedure (p < 0.001). Over a five-year period, our institution saw a significant increase in referrals for infection after total hip arthroplasty (Spearman rank correlation, 1.0; p = 0.0083). However, referral rates for revision for other reasons remained relatively constant (Spearman rank correlation, 0.500; p = 0.3910).
Conclusion: Infections after total hip arthroplasty require significantly more hospital and medical resources than revisions due to aseptic loosening or original total hip arthroplasty.
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References
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