Revision Hip Replacement Risk Highest During First 18 Months

Risk also higher in patients 65 to 75 years old at surgery

FRIDAY, Nov. 2 (HealthDay News) -- Among elderly patients receiving total hip replacements for osteoarthritis, the risk of revision hip replacement is highest in the 18 months after surgery and among those aged 65 to 75 years at time of surgery, according to research published in the Oct. 17 issue of The Journal of Bone & Joint Surgery.

Jeffrey N. Katz, M.D., from Brigham and Women's Hospital in Boston, and colleagues retrospectively analyzed the risks of revision and of death among 51,347 elderly Medicare beneficiaries who had elective total hip replacement for osteoarthritis from 1995 to 1996.

Over a 12-year follow-up period, the researchers found that the risk of revision total hip replacement was highest in the first 18 months, at 2 percent per year, then declining to 1 percent per year. The absolute risk of death was considerably higher than the risk of revision total hip replacement in patients aged ≥75 years at surgery (59 versus 5.7 percent), but less so in patients who were 65 to 75 years old (29 versus 9.4 percent). The relative risk of revision was significantly higher in men versus women (hazard ratio [HR], 1.23); in patients 65 to 75 years old versus ≥75 years at surgery (HR, 1.47); and in patients whose doctors performed fewer than six total hip replacements versus those who performed more than 12 (HR, 1.21).

"Efforts to reduce the number of revision hip arthroplasties should be targeted at revisions occurring in the first 18 months following the index arthroplasty, when revision risk is higher, and at younger patients, who are more likely to survive long enough to require revision," Katz and colleagues conclude.

One or more of the authors disclosed financial ties to an entity in the biomedical arena.

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