Migration Patterns for Revision Total Hip Arthroplasty in the United States as Reported in the American Joint Replacement Registry.
J Arthroplasty
; 36(4): 1401-1406, 2021 04.
Article
en En
| MEDLINE
| ID: mdl-33246785
ABSTRACT
BACKGROUND:
Revision total hip arthroplasty (revTHA) is associated with higher rates of complications and greater costs than primary procedures. The aim of this study is to evaluate the effect of hospital size, teaching status, and indication for revTHA, on migration patterns in patients older than 65 years old.METHODS:
All THAs and revTHAs reported to the American Joint Replacement Registry from 2012 to 2018 were included and merged with the Centers for Medicare and Medicaid Services database. Migration rate was defined as a patient's THA and revTHA procedures that were performed at separate institutions by different surgeons. Migratory patterns were recorded based on hospital size, teaching status, and indication for revTHA. Analyses were performed by statisticians.RESULTS:
The number of linked procedures included was 11,906. Migration rates in revTHA due to infection were higher for small hospitals than large hospitals (46.6% vs 28.6%, P < .0001). Migration rates were higher comparing non-teaching with teaching hospitals (55% vs 34%, P < .0001). This difference was significant for periprosthetic fractures (70.6% vs 37.2%, P = .005), instability (56.5% vs 35.5%, P = .04), and mechanical complications (88.9% vs 34.7%, P < .05). Most patients migrated to medium or large hospitals rather than small hospitals (89% vs 11%, P < .0001) and to teaching rather than non-teaching institutions (82% vs 18%, P < .0001).CONCLUSION:
Hospital size and teaching status significantly affected migration patterns for revTHA. Migration rates were significantly higher in small non-teaching hospitals in revTHA due to infection, periprosthetic fracture, instability, and mechanical complications. Over 80% of patients migrated to larger teaching hospitals.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Artroplastia de Reemplazo de Cadera
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2021
Tipo del documento:
Article