Predictors of Total Hip Arthroplasty Among Patients with Chronic Comorbidities: A Multivariate Analysis of a Medically Underserved Region.

BACKGROUND

THA is a common orthopedic procedure that is expected to increase in the coming years. Obesity and osteoarthritis are major factors that increase the risk of individuals requiring THA. The Rio Grande Valley (RGV) is a distinctive health professional shortage area with high rates of obesity, arthritis, and diabetes. This study aims to examine the relationship between chronic medical conditions and the need for THA in this at-risk, medically underserved population.

METHODS

This investigation employed a retrospective chart review encompassing patient records from January 1, 2018, through January 1, 2025, using the University of Texas Rio Grande Valley electronic medical record system. ICD-10 codes were used to identify patients with a range of pre-existing medical conditions. CPT codes were utilized to identify patients who underwent THA. Bivariate and multivariate analyses were conducted, and results were expressed as odds ratios (ORs) with corresponding 95% confidence intervals.

RESULTS

Multivariate analysis showed that being overweight/obese (OR = exp (0.656) ≈ 1.93, p = 0.005) had significantly increased odds of having THA. Individuals with T2DM (OR = exp (-1.109) ≈ 0.33, p < 0.001) had decreased odds of THA compared to individuals without T2DM. Individuals who were overweight/obese had nearly two times increased odds of surgery compared to individuals who were not overweight/obese and individuals with T2DM had 67% reduced odds of THA.

CONCLUSION

These findings underscore the importance of chronic comorbidities as risk factors and the multifactorial nature of surgical decision-making in hip arthroplasty, especially in a medically underserved, chronic disease-stricken population.