Characterizing the Cost Trends of Readmissions after Aseptic Revision Total Hip Arthroplasty.

Abstract

As the prevalence of primary total hip arthroplasty (pTHA) rises in the United States, there is a corresponding increase in revision total hip arthroplasty (rTHA), particularly among younger patients. This study explored the etiologies, financial burdens, and risk factors for 90-day readmission following aseptic rTHA, with an emphasis on distinguishing these factors from septic revision cases. This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022. Patients undergoing aseptic rTHA were identified via Current Procedural Terminology (CPT) codes. Readmissions within 90 days postoperatively were analyzed. Baseline characteristics, comorbidities, and readmission costs were compared, and significant risk factors for readmission were identified. Of the 36,212 patients who underwent aseptic rTHA, 3,822 (10.6%) experienced at least one readmission within 90 days. The median cost of readmission was $41,148, with costs significantly higher in cases requiring reoperation. The primary surgical complications leading to readmission were periprosthetic joint infection (PJI), "other mechanical complications" and dislocation. Notable risk factors for readmission included different indications for index rTHA and comorbidities of morbid obesity, active smoking, and rheumatic disease. Readmission following aseptic rTHA places a significant economic burden on the healthcare system, with certain patient comorbidities and surgical complications influencing postoperative readmissions and additional costs. Identifying these risk factors underscores the need for targeted interventions aimed at minimizing the frequency and severity of readmissions, thereby enhancing patient outcomes and reducing healthcare expenditures.