Hypothyroidism Increases 90-Day Complications and Cost Following Primary Total Hip Arthroplasty

2019 ◽  
Vol 03 (02) ◽  
pp. 062-067
Author(s):  
Dhanur Damodar ◽  
Ajit Vakharia ◽  
Erik Zachwieja ◽  
Rushabh Vakharia ◽  
Victor Hernandez ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
The United States ◽  
Cost Of Care ◽  
The Body ◽  
Readmission Rates ◽  
Total Hip ◽  
Increased Risk ◽  
Primary Total Hip Arthroplasty

AbstractHypothyroidism is common, and the incidence has been increasing annually in the United States. Abnormalities in thyroid hormone can have several effects on the endocrine, immune, and musculoskeletal systems of the body. The influence of hypothyroidism on outcomes following primary total hip arthroplasty (THA) is not well reported. The authors hypothesized that hypothyroidism was associated with a higher risk of postoperative complications and 90-day costs following primary THA. A retrospective review from 2005 to 2014 was performed using the Medicare Standard Analytical Files from the Pearl Diver database. Utilizing International Classification of Disease 9th revision (ICD-9) codes, the authors identified patients who underwent THA. Patients with a concurrent diagnosis of hypothyroidism were matched by age, gender, and Charlson's comorbidity index (CCI) to a control group. Ninety-day postoperative complications, readmission rates, complications related to implants, and cost of care were compared and assessed following primary THA between matched cohorts. Statistical analysis was performed using the programming language R (University of Auckland) to calculate odds ratios (OR) along with their respective 95% confidence intervals (95% CI), and p-values. A total of 383,898 patients underwent primary THA. Among them, 191,949 patients were diagnosed with hypothyroidism and 191,949 patients without hypothyroidism. Hypothyroidism was associated with greater odds of postoperative complications (p < 0.001), 90-day readmission rates (p < 0.001), implant related complications (p < 0.001), and total global 90-day episode of care cost (U.S. $17,549.96 vs. $16,645.01; p < 0.001). This study demonstrated an increased risk of postoperative complications (medical or implant related), increased readmission rates, and higher costs among patients with hypothyroidism following primary THA. Surgeons should counsel patients and determine strategies to medically optimize patients to mitigate risk and decrease cost.

Factors Affecting Readmission Rates Following Primary Total Hip Arthroplasty

2014 ◽  
Vol 96 (14) ◽  
pp. 1201-1209 ◽  
Author(s):  
Rachel E Mednick ◽  
Hasham M Alvi ◽  
Varun Krishnan ◽  
Francis Lovecchio ◽  
David W Manning
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Readmission Rates ◽  
Factors Affecting ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Conversion vs Primary Total Hip Arthroplasty: Increased Cost of Care and Perioperative Complications

2018 ◽  
Vol 33 (8) ◽  
pp. 2405-2411 ◽  
Author(s):  
Sean P. Ryan ◽  
Marcus DiLallo ◽  
David E. Attarian ◽  
William A. Jiranek ◽  
Thorsten M. Seyler
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Cost Of Care ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals The usefulness of dual mobility cups in primary total hip arthroplasty patients at a risk of dislocation

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Dual Mobility ◽  
Total Hip ◽  
Early Results ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

Extremes of body mass index have significant impact on complications, readmissions, and utilization of post-acute services after primary total hip arthroplasty

2020 ◽  
Vol 102-B (7_Supple_B) ◽  
pp. 62-70
Author(s):  
Geoffrey Tompkins ◽  
Chris Neighorn ◽  
Hsin-Fang Li ◽  
Kevin Fleming ◽  
Tom Lorish ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Operating Time ◽  
Inpatient Cost ◽  
Complication Rates ◽  
Total Hip ◽  
Increased Risk ◽  
Primary Total Hip Arthroplasty

Aims High body mass index (BMI) is associated with increased rates of complications in primary total hip arthroplasty (THA), but less is known about its impact on cost. The effects of low BMI on outcomes and cost are less understood. This study evaluated the relationship between BMI, inpatient costs, complications, readmissions, and utilization of post-acute services. Methods A retrospective database analysis of 40,913 primary THAs performed between January 2013 and December 2017 in 29 hospitals was conducted. Operating time, length of stay (LOS), complication rate, 30-day readmission rate, inpatient cost, and utilization of post-acute services were measured and compared in relation to patient BMI. Results Mean operating time increased with BMI and for BMI > 50 kg/m2 was approximately twice that of BMI 10 kg/m2 to 15 kg/m2. Mean inpatient cost did not vary significantly with BMI. Mean total reimbursement was lowest for the lowest BMI cohort and increased with BMI. Mean LOS was greatest at the extremes of BMI (4.0 days for BMI 10 kg/m2 to 15 kg/m2; 3.75 days for BMI > 50 kg/m2) and twice that of normal BMI. Mean complication rates were greatest in the lowest BMI cohort (16% for BMI 10 kg/m2 to 15 kg/m2) and five times the mean rate of complications in the normal BMI cohorts. Furthermore, 30-day readmissions were greatest in the highest BMI cohort (10% for BMI > 50 kg/m2) and five times the rate for normal BMI patients. Conclusion LOS, complications, and 30-day readmissions all increase at the extremes of BMI and appear to be greater than those of patients with normal BMI. The lowest BMI patients had the lowest payment for inpatient stay yet were at considerable risk for complications and readmission. Patients with extreme BMI should be counselled about their increased risk of complications for THA and nutritional status/obesity optimized preoperatively if possible. Cite this article: Bone Joint J 2020;102-B(7 Supple B):62–70.

scholarly journals Dual Mobility Cups Present Promising Outcomes in Primary Total Hip Arthroplasty Patients At A Risk of Dislocation

2021 ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Dual Mobility ◽  
Total Hip ◽  
Early Results ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

Abstract Introduction This study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. Materials and methods This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Results Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. Conclusion The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

Decreasing Length of Hospital Stay and Postoperative Complications After Primary Total Hip Arthroplasty: A Decade Analysis From 2006 to 2016

2019 ◽  
Vol 34 (3) ◽  
pp. 422-425 ◽  
Author(s):  
Matthew J. Grosso ◽  
Alexander L. Neuwirth ◽  
Venkat Boddapati ◽  
Roshan P. Shah ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Length Of Hospital Stay ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Primary total hip arthroplasty for displaced intracapsular fracture of the femoral neck: Medium-term functional and radiographic outcomes

Open Medicine ◽  
2008 ◽  
Vol 3 (2) ◽  
pp. 207-213
Author(s):  
Valér Džupa ◽  
Pavel Pazdírek ◽  
Vladimír Pacovský ◽  
Jan Bartoníček ◽  
Jiří Skála-Rosenbaum
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Intracapsular Fracture ◽  
Intraoperative Complication ◽  
Total Hip ◽  
Early Postoperative Complications ◽  
Primary Total Hip Arthroplasty

AbstractThe number of complications after primary total hip arthroplasty for displaced intracapsular fractures of the femoral neck is higher than that after operations for osteoarthritis. The aim of this study is to evaluate the number of complications and mid-term functional and radiological findings of patients after primary THA for displaced intracapsular fractures of the femoral neck. Between 1995 and 1998, we operated on a total of 89 patients for acute displaced intracapsular fractures of the femoral neck, i.e. Garden Type 3 and 4. In all the patients we evaluated intraoperative and early postoperative complications. We reviewed clinical and radiological results in 65 patients. The only intraoperative complication was abruption of the greater trochanter. Early postoperative complications occurred in 13 patients (15%). The specific complications, THA dislocation, occurred in 3 patients. Non-specific complications were recorded in 10 patients. No delayed healing of the surgical wound, neural lesion or early, delayed or late infection was recorded. Of 65 patients followed-up for an average of 78 months (range, 62–109 months), 8 patients underwent revision surgery. Of 57 patients with primary THA, very good and good clinical results according to the Harris Hip Score were recorded in 48 patients (84%) and poor results in only 2 patients (4%). Nine of 57 followed-up patients showed radiological signs of loosening (16%). The radiolucent line could be seen in 3 patients in the region of the cup, in 1 patient in the region of the femoral component and in 5 patients in both components. Clinical complaints that would result in indication for reimplantation were recorded in none of the mentioned patients. Number of complications, functional results and resumption of full self-reliance by patients after THA for an intracapsular fracture of the femoral neck are so positive that we consider the indication of THA for a displaced femoral neck fracture fully justified.

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