title: Early morbidity after aseptic revision hip arthroplasty in Denmark: a two-year nationwide study.
abstract: Data on early morbidity and complications after revision total hip replacement (THR) are limited. The aim of this nationwide study was to describe and quantify early morbidity after aseptic revision THR and relate the morbidity to the extent of the revision surgical procedure. We analysed all aseptic revision THRs from 1st October 2009 to 30th September 2011 using the Danish National Patient Registry, with additional information from the Danish Hip Arthroplasty Registry. There were 1553 procedures (1490 patients) performed in 40 centres and we divided them into total revisions, acetabular component revisions, femoral stem revisions and partial revisions. The mean age of the patients was 70.4 years (25 to 98) and the median hospital stay was five days (interquartile range 3 to 7). Within 90 days of surgery, the readmission rate was 18.3%, mortality rate 1.4%, re-operation rate 6.1%, dislocation rate 7.0% and infection rate 3.0%. There were no differences in these outcomes between high- and low-volume centres. Of all readmissions, 255 (63.9%) were due to 'surgical' complications versus 144 (36.1%) 'medical' complications. Importantly, we found no differences in early morbidity across the surgical subgroups, despite major differences in the extent and complexity of operations. However, dislocations and the resulting morbidity represent the major challenge for improvement in aseptic revision THR.
authors.affiliation: Copenhagen University Hospital Rigshospitalet, Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Lindberg-Larsen
authors.affiliation: Copenhagen University Hospital Rigshospitalet, Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: C C
authors.initials: CC
authors.lastname: Jørgensen
authors.affiliation: Holstebro Regional Hospital, Department of Orthopaedic Surgery, Lægårdvej 12, 7500 Holstebro, Denmark.
authors.forename: T B
authors.initials: TB
authors.lastname: Hansen
authors.affiliation: Copenhagen University Hospital Gentofte , Department of Orthopaedic Surgery, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Solgaard
authors.affiliation: Copenhagen University Hospital Rigshospitalet, Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Kehlet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Fast-track; Length of stay; Morbidity; Mortality; Nationwide; Readmission; Reoperation; Revision; Total hip arthroplasty