Total Hip Revisions – Worsening Adverse Events Are The Long Term Trend

Hip replacement surgery is a common surgical procedure that many individuals face as they age. The hope for these patients is that a hip replacement procedure will enable them to continue living an active, pain-free lifestyle for many more years. Now, a recent study out of the University of Iowa is putting some details on the long-term results of these procedures. Specifically, the researchers examined adverse events—or complications—associated with hip replacement for older patients.

The study, which was released in July, was conducted by a team of researchers from the University of Iowa Department of Orthopaedics and Rehabilitation and the Department of Internal Medicine. They focused on Medicare beneficiaries, looking at nearly 1.5 million patients who underwent total hip replacement and another 337,000 who underwent a revision total hip replacement between the years of 1991 and 2008. The researchers were particularly interested in patients who suffered adverse events including death, hemorrhage, infection, pulmonary embolism, sepsis, deep venous thrombosis, and myocardial infraction.

The results of the study indicate that the trend for hip replacement patients is an increase in adverse events. Over the 17 year period that the researchers looked at, there was an increase in adverse events for all total hip replacement patients. There was also an increase in the rate of patients being readmitted for any cause, with that rate over 10% for first-time hip replacement patients and over 20% for revision hip replacement patients. Adverse events are particularly noteworthy in patients undergoing a revision surgery. The adverse outcome rate for these patients increased from 7% to 10.9% over the period studied. The researchers attribute this, in part, to the surgical complexity that these types of patients present.

Of course, these numbers need continued monitoring to see if we are heading in the direction of more complications for hip replacement patients. Undergoing the procedure and recovery is a serious physical and psychological commitment for an individual patient, and awareness of the likely outcomes is a must.