Risk factors ID'd for revision of total hip replacement

(HealthDay)—Younger, taller, and heavier patients who undergo primary total hip replacement (THR) are at a greater risk of needing a revision surgery, according to research published in the December issue of Arthritis Care & Research.

Elizabeth A. Wright, Ph.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues used Medicare claims data for 29 states to examine risk factors for revision of primary THR in a sample of 836 beneficiaries (aged 65 and older) who underwent primary THR and 836 matched controls.

Complete information was available for 719 case-control pairs. The researchers found that, in multivariate analysis, factors that correlated with increased odds of revision included patient age ≤75 years at primary surgery (odds ratio [OR], 1.52); height or weight in the highest tertile (OR, 1.40 and 1.66, respectively); cemented femoral component (OR, 1.44); previous contralateral THR (OR, 1.36); other orthopedic surgery (OR, 1.45); and living with others versus living alone (OR, 1.26).

"This study of a Medicare population emphasizes that age between 65 and 75 years and greater height and weight at the time of the THR are potent risks for failure of THR leading to revision surgery," the authors write. "We conclude that the effects of age and larger body size on revision risk should be included in discussions between surgeons and patients about the potential risk of failure of a primary THR."

One author reported serving as an expert witness for litigation regarding total hip replacement implants.

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