Age, gender influence hip arthroplasty revision risk

By Nikki Withers, medwireNews Reporter

Patient age and gender have a significant effect on the risk for revisions after primary total hip replacement, show study findings.

The researchers found that men had significantly higher rates of revisions than women, and that younger patients (those aged between 65 and 75 years at the time of primary total hip replacement) had a higher rate than older patients.

The findings are published in The Journal of Bone and Joint Research.

The research team, led by Jeffrey Katz (Brigham and Women's Hospital, Boston, Massachusetts, USA), retrospectively analyzed data from more than 51,000 Medicare beneficiaries who had primary total hip replacements between July 1995 and June 1996. Patients were followed up until 2008.

Overall, the risk for revision after total hip replacement for patients remaining alive was approximately 2% per year for the first 18 months and 1% per year for the remainder of the follow-up period.

Multivariate analysis showed that men were 23% more likely to undergo revision than women, something that the researchers say should be addressed in further investigations.

Patients aged 65-75 years at the time of primary total hip replacement were 47% more likely to undergo revision than their older counterparts.

This, say Katz et al, has "important implications for patient decision-making, quality improvement and research."

The researchers also found that patients of surgeons who performed fewer than six total hip replacements per year were at a 21% higher risk for revision than those whose surgeons performed more than 12 per year.

"Our findings suggest that the development of innovative technologies to improve implant longevity should target younger populations with advanced arthritis who have a longer anticipated time span in which the implants might fail and require revision arthroplasty," write the researchers.

Arthroplasties "should be targeted at revisions occurring in the first 18 months following the index arthroplasty, when revision risk is higher, and in younger patients, who are more likely to survive long enough to require revision," the team concludes.

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