The Outcomes and Revision Rate of Total Hip Arthroplasty in a Single Tertiary Center: A Retrospective Study

Khalid A Alsheikh; Ali A Alhandi; Mutlaq S Almutlaq; Lina A Alhumaid; Naila Shaheen

doi:10.7759/cureus.27981

The Outcomes and Revision Rate of Total Hip Arthroplasty in a Single Tertiary Center: A Retrospective Study

Cureus. 2022 Aug 13;14(8):e27981. doi: 10.7759/cureus.27981. eCollection 2022 Aug.

Authors

Khalid A Alsheikh¹, Ali A Alhandi², Mutlaq S Almutlaq³, Lina A Alhumaid⁴, Naila Shaheen⁵

Affiliations

¹ Department of Orthopedics, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.
² Department of Orthopedics, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, SAU.
³ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.
⁴ College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
⁵ Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, SAU.

Abstract

Introduction Total hip arthroplasty (THA) is a commonly performed and successful orthopedic practice procedure. However, failure of arthroplasty may require revision THA and pose substantial clinical challenges for orthopedic surgeons. Therefore, this retrospective study aimed to estimate the revision rate of THA and its risk factors at a tertiary care hospital. Methods A retrospective cohort study was conducted in 2021 of patients who had undergone THA during 2016-2020 in a tertiary care hospital. All patients above 18 years old who had a THA were included in the study. The data was collected from patients' medical charts/electronic databases. Results A total of 148 THAs were included in this study. In total, 77 (52%) were females, and 71 (48%) were males. The average age of our patients was 49±17 years old, and the mean recorded BMI was 29.6. A total of 62% (n=92/148) of our participants were shown to have at least one comorbid disease, with hypertension being the most common comorbidity. Our findings show that half of the patients, 74 (50%), had a THA due to both primary and secondary osteoarthritis, 37 (25%) patients had avascular necrosis of the hip, and 25 (17%) were due to trauma. The most performed surgical approach was Kocher-Langenbeck (posterior) approach on 128 (86%), followed by the Hardinge (lateral) approach on 20 (13.51%). The most observed complication in the patients was postoperative pain in 35 (23.65%), followed by UTIs in 5 (3.38%). Of the 148 patients, nine (6.08%) had revision surgery. Regarding the revision rate, male patients were associated with a significantly higher rate of revision (P=<0.001), and older patients had a significantly increased risk of revision (P=0.026). Patients who developed complications, such as UTI, were associated with a higher revision rate (P=0.035). Also, a posterior approach (Kocher-Langenbeck) of the procedure was significantly linked to an increased risk of revision (P=0.014). Conclusion All in all, there are multiple associated factors with an increased incidence of revision THA. For example, male patients, older patients, complication development during the hospital stay, and posterior surgical approach were all associated with a significantly higher rate of revision.

Keywords: revision joint replacement; revision operation; revision total joint arthroplasty; tertiary care centers; total hip arthroplasty: tha.