Short-Term Complications of Revision Total Hip Arthroplasty of the Acetabular, Femoral, or Both Components: A National Surgical Quality Improvement Program Database Study.

BACKGROUND

Revision total hip arthroplasties (rTHA) are increasingly prevalent. Depending on the wear of implanted components the surgeon can replace the acetabular, femoral, or both components. The purpose of this study was to elucidate the differential outcomes and complications of rTHA by component(s) replaced.

METHODS

Patients who underwent rTHA from 2010 to 2020 in the National Surgical Quality Improvement Program database were included. Propensity score matching was performed based on patient demographics and comorbidities. The independent variable was component(s) replaced. The dependent variables were complications. A binary logistic regression was performed to determine the odds ratio and 95% confidence intervals.

RESULTS

The rate of adverse events from highest to lowest was revision of the femoral component (38.1%), both components (29.8%), then the acetabular component (21.9%). The linear regression performed on all rTHAs revealed older age, dependent functional status, longer operative time, longer length of stay, higher American Society of Anesthesiologists class, congestive heart failure, steroid use, malnourishment, bleeding disorder, and preoperative transfusion were associated with an increased risk of any adverse event (AAE).

CONCLUSIONS

The overall rate of AAE for rTHA in the 30-day postoperative period was 29.8%. Compared to revising both components, revising the femoral component had higher rates of AAE, death, and transfusion while revising the acetabular component had lower rates of AAE, sepsis, pulmonary embolism, transfusion, and deep vein thrombosis. Identification of these complication rates after rTHA, along with patient risk factors for adverse events can help surgeons be aware of certain complications when specific components need to be revised.