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Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018

BACKGROUND: As primary total hip arthroplasty volume continues to increase, so will the number of revision total hip arthroplasty (rTHA) procedures. These complex cases represent a significant clinical and financial burden to the health-care system. METHODS: This was a retrospective review using the...

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Autores principales: Upfill-Brown, Alex, Hsiue, Peter P., Sekimura, Troy, Patel, Jay N., Adamson, Micah, Stavrakis, Alexandra I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413665/
https://www.ncbi.nlm.nih.gov/pubmed/34504922
http://dx.doi.org/10.1016/j.artd.2021.08.001
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author Upfill-Brown, Alex
Hsiue, Peter P.
Sekimura, Troy
Patel, Jay N.
Adamson, Micah
Stavrakis, Alexandra I.
author_facet Upfill-Brown, Alex
Hsiue, Peter P.
Sekimura, Troy
Patel, Jay N.
Adamson, Micah
Stavrakis, Alexandra I.
author_sort Upfill-Brown, Alex
collection PubMed
description BACKGROUND: As primary total hip arthroplasty volume continues to increase, so will the number of revision total hip arthroplasty (rTHA) procedures. These complex cases represent a significant clinical and financial burden to the health-care system. METHODS: This was a retrospective review using the National Inpatient Sample. International Classification of Diseases, 9th and 10(th) revision codes were used to identify patients who underwent rTHA and create cohorts based on rTHA indications from 2012 to 2018. National and regional trends for length of stay (LOS), cost, and discharge location were evaluated. RESULTS: A total of 292,250 rTHA procedures were identified. The annual number of rTHA procedures increased by 28.1% from 2012 to 2018 (37,325 to 47,810). The top 3 indications for rTHA were instability (20.4%), aseptic loosening (17.8%), and infection (11.1%). Over the study period, the proportion of patients discharged to skilled nursing facility decreased from 44.2% to 38% (P < .001). Hospital LOS decreased on average from 4.8 to 4.4 days (P < .001). Infections had the highest average LOS (7.3 days) followed by periprosthetic fractures (6.5 days). Hospital costs decreased over the study period, from $25,794 to $24,555 (P < .001). The proportion of rTHA cases performed at urban academic centers increased (58.0% to 75.3%, P < .001) while the proportion performed at urban nonacademic centers decreased (35.5% to 19.4%, P < .001). CONCLUSION: Instability was the most common indication for rTHA between 2012 and 2018. The proportion of rTHA performed in urban academic centers has increased substantially, away from urban nonacademic centers. While cost and LOS have decreased, significant geographic variability exists.
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spelling pubmed-84136652021-09-08 Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018 Upfill-Brown, Alex Hsiue, Peter P. Sekimura, Troy Patel, Jay N. Adamson, Micah Stavrakis, Alexandra I. Arthroplast Today Original Research BACKGROUND: As primary total hip arthroplasty volume continues to increase, so will the number of revision total hip arthroplasty (rTHA) procedures. These complex cases represent a significant clinical and financial burden to the health-care system. METHODS: This was a retrospective review using the National Inpatient Sample. International Classification of Diseases, 9th and 10(th) revision codes were used to identify patients who underwent rTHA and create cohorts based on rTHA indications from 2012 to 2018. National and regional trends for length of stay (LOS), cost, and discharge location were evaluated. RESULTS: A total of 292,250 rTHA procedures were identified. The annual number of rTHA procedures increased by 28.1% from 2012 to 2018 (37,325 to 47,810). The top 3 indications for rTHA were instability (20.4%), aseptic loosening (17.8%), and infection (11.1%). Over the study period, the proportion of patients discharged to skilled nursing facility decreased from 44.2% to 38% (P < .001). Hospital LOS decreased on average from 4.8 to 4.4 days (P < .001). Infections had the highest average LOS (7.3 days) followed by periprosthetic fractures (6.5 days). Hospital costs decreased over the study period, from $25,794 to $24,555 (P < .001). The proportion of rTHA cases performed at urban academic centers increased (58.0% to 75.3%, P < .001) while the proportion performed at urban nonacademic centers decreased (35.5% to 19.4%, P < .001). CONCLUSION: Instability was the most common indication for rTHA between 2012 and 2018. The proportion of rTHA performed in urban academic centers has increased substantially, away from urban nonacademic centers. While cost and LOS have decreased, significant geographic variability exists. Elsevier 2021-08-31 /pmc/articles/PMC8413665/ /pubmed/34504922 http://dx.doi.org/10.1016/j.artd.2021.08.001 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Research
Upfill-Brown, Alex
Hsiue, Peter P.
Sekimura, Troy
Patel, Jay N.
Adamson, Micah
Stavrakis, Alexandra I.
Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title_full Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title_fullStr Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title_full_unstemmed Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title_short Instability Is the Most Common Indication for Revision Hip Arthroplasty in the United States: National Trends From 2012 to 2018
title_sort instability is the most common indication for revision hip arthroplasty in the united states: national trends from 2012 to 2018
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413665/
https://www.ncbi.nlm.nih.gov/pubmed/34504922
http://dx.doi.org/10.1016/j.artd.2021.08.001
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