Are Hooded, Crosslinked Polyethylene Liners Associated with a Reduced Risk of Revision After THA?

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Each author certifies that he or she has no commercial associations (eg consultancies, stock ownership, equity interest, patent/licensing arrangements etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. 11. Int Orthop. 2020 Nov;44(11):2243-2252. doi: 10.1007/s00264-020-04682-y. Epub 2020 Jun 27. Incidence and risk factors of in-hospital prosthesis-related complications following total hip arthroplasty: a retrospective Nationwide Inpatient Sample database study. Yang Q(#)(1), Wang J(#)(1), Xu Y(1), Chen Y(1), Lian Q(1), Zhang Y(2). Author information: (1)Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. (2)Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. nfgjzy@126.com. (#)Contributed equally PURPOSE: The occurrence of prosthesis-related complications (PRCs) after total hip arthroplasty (THA) is devastating, commonly meaning implant failure and revision surgery. The purpose was to examine the incidence and risk factors of in-hospital PRCs following THA using a large-scale national database. METHODS: A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2005 to 2014. Patients who underwent THA were included. Patient demographics, hospital characteristics, length of stay (LOS), economic indicators, in-hospital mortality, comorbidities, and peri-operative complications were evaluated. RESULTS: A total of 590,122 THAs were obtained from the NIS database. The general incidence of in-hospital PRCs after THA was 1.96%, with a slight downward trend annually. Dislocation was the most common PRCs (0.23%). Patients with PRCs after THA demonstrated increased LOS, total charges, usage of Medicare, and in-hospital mortality. Risk factors of PRCs included advanced age, female, the Hispanic, the Native American, large hospital, teaching hospital, hospital in the South, Medicaid, Self-pay, alcohol abuse, anemia, coagulopathy, rheumatoid diseases, neurological disorders, depression, paralysis, psychosis, diabetes, fluid and electrolyte disorders, congestive heart failure, chronic pulmonary disease, liver disease, metastatic cancer, and weight loss. Additionally, PRCs were associated with avascular necrosis, ankylosing spondylitis, rheumatoid arthritis, femoral neck fracture, dementia, osteoporosis, acute renal failure, acute myocardial infarction, pneumonia, post-operative delirium, urinary tract infection, deep vein thrombosis, transfusion, sepsis, post-operative shock, wound dehiscence, haemorrhage/seroma/haematoma, and nerve injury. CONCLUSION: A relatively low incidence of in-hospital PRCs after THA was identified. It is of benefit to study risk factors of PRCs to ensure the appropriate management and moderate consequences. DOI: 10.1007/s00264-020-04682-y