This study analyzed 51,345 revision THA procedures from the HCUP Nationwide Inpatient Sample (October 2005 to December 2006). It was the first national analysis to characterize revision THA by specific mechanism of failure and procedure type, made possible by newly implemented ICD-9-CM codes. The central question: what is actually driving revision THA across the United States, in all hospital types?
When a patient asks why their THA might eventually need revision, the most honest answer based on national data is: instability first, loosening second, infection third. This paper inverted the prior assumption that aseptic loosening was the dominant failure mode.
When counseling patients preoperatively, particularly those at higher dislocation risk (prior hip surgery, neuromuscular disease, posterior approach), this data supports aggressive discussion of component positioning, approach selection, and head size — because instability is now the leading reason people go back to the OR.
When you see an infected THA requiring a two-stage revision, plan for nearly double the hospital resource consumption of any other revision type (LOS 11.8 days, charges $69,380). This is the basis for how hospitals budget and how payers authorize these admissions.
The paper also highlights that most revision THA happens in community hospitals, not academic centers. Familiarity with the ICD-9-CM revision codes and accurate operative documentation directly affects how institutional data is captured and how performance is publicly reported.
This study analyzed 51,345 revision THA procedures from the HCUP Nationwide Inpatient Sample (October 2005 to December 2006). It was the first national analysis to characterize revision THA by specific mechanism of failure and procedure type, made possible by newly implemented ICD-9-CM codes. The central question: what is actually driving revision THA across the United States, in all hospital types?
When a patient asks why their THA might eventually need revision, the most honest answer based on national data is: instability first, loosening second, infection third. This paper inverted the prior assumption that aseptic loosening was the dominant failure mode.
When counseling patients preoperatively, particularly those at higher dislocation risk (prior hip surgery, neuromuscular disease, posterior approach), this data supports aggressive discussion of component positioning, approach selection, and head size — because instability is now the leading reason people go back to the OR.
When you see an infected THA requiring a two-stage revision, plan for nearly double the hospital resource consumption of any other revision type (LOS 11.8 days, charges $69,380). This is the basis for how hospitals budget and how payers authorize these admissions.
The paper also highlights that most revision THA happens in community hospitals, not academic centers. Familiarity with the ICD-9-CM revision codes and accurate operative documentation directly affects how institutional data is captured and how performance is publicly reported.