Logo image
Back
Risk of Subsequent Revision after Primary and Revision Total Joint Arthroplasty
Journal article   Open access   Peer reviewed

Risk of Subsequent Revision after Primary and Revision Total Joint Arthroplasty

Kevin L. Ong, Edmund Lau, Jeremy Suggs, Steven M. Kurtz and Michael T. Manley
Clinical orthopaedics and related research, v 468(11), pp 3070-3076
01 Nov 2010
DOI: https://doi.org/10.1007/s11999-010-1399-0
PMID: 20499292
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1007/s11999-010-1399-0View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology Surgery
Background Revision is technically more demanding than primary total joint arthroplasty (TJA) and requires more extensive use of resources. Understanding the relative risk of rerevision and risk factors can help identify patients at high risk who may require closer postsurgical care. Objectives/purposes We therefore evaluated the risk of subsequent revision after primary and revision TJA in the elderly (65 years or older) patient population and identified corresponding patient risk factors. Patients and Methods Using the 5% Medicare claims data set (1997-2006), we identified a total of 35,746 patients undergoing primary THA and 72,913 undergoing primary TKA; of these, 1205 who had THAs and 1599 who had TKAs underwent initial revision surgery. The rerevision rate after primary and revision TJAs was analyzed by the Kaplan-Meier method. The relative risk of revision surgery for primary and revision TJAs was compared using hazard ratio analysis. Results The 5-year survival probabilities were 95.9%, 97.2%, 81.0%, and 87.4% for primary THA and TKA and revision THA and TKA, respectively. Patients with revision arthroplasty were five to six times more likely to undergo rerevision (adjusted relative risk, 4.89 for THA; 5.71 for TKA) compared with patients with primary arthroplasty. Age and comorbidities were associated with initial revision after primary THA and TKA. Conclusions Patients should undergo stringent preoperative screening for preexisting health conditions and careful patient management and followup postoperatively so as to minimize the risk of an initial revision, which otherwise could lead to a significantly greater likelihood of subsequent rerevisions. Level of Evidence Level II, prognostic study. See Guideline for Authors for a complete description of levels of evidence.

Metrics

13 Record Views
236 citations in Web of Science
238 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Orthopedics
Surgery
Logo image