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· DOS Abstracts
Early morbidity after aseptic revision hip arthroplasty in
Denmark. A 2 year nationwide study.
Martin Lindberg-Larsen, Christoffer Calov Jørgensen , Torben Bæk Hansen,
Søren Solgaard, Henrik Kehlet
Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track
Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen University, Denmark;
Department of Orthopaedic Surgery and The Lundbeck Centre for Fast-track
Hip and Knee Arthroplasty, Holstebro Regional Hospital, Holstebro, Denmark
Background:
Limited data exist on early morbidity after revision total hip ar-
throplasty (RTHA).
Purpose / Aim of Study:
To describe early morbidity after aseptic RTHA and
relate the morbidity to the extent of the revision procedure.
Materials and Methods:
All aseptic RTHA procedures from 2009 to 2011
were analysed using the Danish National Patient Registry with additional infor-
mation from the Danish Hip Arthroplasty Registry. The procedures were divided
into total revisions, acetabular cup revisions, femoral stem revisions and partial
revisions. All readmissions and in- hospital complications were analyzed based
upon detailed evaluation of patient records and causes were divided into “surgi-
cal” and “medical” complications.
Findings / Results:
1553 procedures were performed in 40 centres. The mean
age was 70.4 years (range: 25-98) and median length of hospital stay (LOS) 5
days (interquartile range, IQR: 3-7). Within 90 days postoperatively the read-
mission rate was 18.3% and mortality rate 1.4%. The 90-day reoperation rate
was 6.1%, dislocation rate 7.0% and infection rate 3.0%. Of all readmissions,
63.9% were due to “surgical” complications vs. 36.1% “medical” complications.
The duration of surgery, bone loss, intraoperative complications and LOS indi-
cated that the total revisions and femoral stem revisions represented the most
complex surgery, but there were no differences in early morbidity across the
surgical subgroups.
Conclusions:
Aseptic RTHA was performed with LOS of 5 days and without
differences in early morbidity across revision subgroups despite major differ-
ences surgical extent. All types of RTHA were associated with increased early
morbidity compared to primary hip arthroplasty. The results from this study
suggest that future focus should be held on the surgical technique as well as the
perioperative set-up according to the “fast-track” methodology.
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