Thirty-Day Readmissions After Aseptic Revision Total Hip Arthroplasty: Rates, Predictors, and Reasons Vary by Surgical Indication

Abstract Background Revision total hip arthroplasty (rTHA) is performed for different surgical indications. With increasing attention being focused to minimize readmission risk, the National Surgical Quality Improvement Program (NSQIP) was used to assess 30-day readmissions following rTHA for three aseptic indications. Methods Patients undergoing rTHA were identified in the 2013-2017 NSQIP and classified as being performed for osteolysis/aseptic loosening, recurrent dislocation, or periprosthetic fracture. Rates and predictors of 30-day readmission were determined by indication. Reasons for readmission were also assessed as being either related or unrelated to the surgical site. Results Of 6,104 patients meeting inclusion criteria, osteolysis/aseptic loosening represented 46% of the revisions (readmission rate: 6.2%), recurrent dislocation represented 33.2% (readmission rate: 10.9%) and periprosthetic fractures represented 20.9% (readmission rate: 9.3%). These readmission rates represented statistically significant variation across the three indications (p The osteolysis/aseptic loosening and periprosthetic fracture cohorts had surgical site-related readmissions in 43.9% and 42.4% of readmitted cases, respectively. On the contrary, readmissions after rTHA performed for recurrent dislocation were mostly surgical site-related (63.3%) and driven primarily by a postoperative dislocation. Further multivariate analysis showed that the rTHA indication of recurrent dislocation itself was the strongest predictor (OR: 3.34; p Conclusion Thirty-day readmissions varied from 6.2% to 10.9% based on surgical indication for aseptic rTHA. Reasons for readmission also differed across the three cohorts. These findings may aid postoperative care pathways and protocol optimization.