![]() ![]() Through analysis of surgical indication code by ICD-10 and through registration of the surgeons of the cause for revision in the Arthroplasty Registry, all aseptic revisions were classified according to reason for revision. ![]() All failures of THA not matching the EBJIS criteria for PJI were categorized as aseptic failure. According to European Bone and Joint Infection Society (EBJIS) guidelines, a definition of periprosthetic joint infection was obtained by surgeons and coded as PJI and therefore registered as septic failure in the registry. Failure of THA was determined by analysis of reasons for revision through a search of the ICD-10 code (ICD-10: T84.–) during revision surgery in the registry and registration by surgeons during the data input of arthroplasty register. In addition to comorbidities, all other billing diagnoses are recorded in the arthroplasty registry and used to determine influencing factors. Mortality after implantation was determined by matching arthroplasty data with deaths recorded in insurance data. The Elixhauser score is an index that pools a variety of comorbidities of different organ systems and entities. Patients with THA for the treatment of primary OA and for the treatment of FNF were matched according to age, sex, body mass index (BMI), cementation technique, and Elixhauser comorbidity score (in the van Walraven variant) using Mahalanobis distance matching in a 1:1 ratio. For the analysis patients were divided into subpopulations according to the reason for THA implantation. Patients with THA for the treatment of primary osteoarthritis (ICD-10: M16.0 and M16.1) and after femoral neck fracture as main diagnosis (ICD-10: S72.0–) between 1 January 2013 and 3 December 2022 were included in the present analysis of the German Arthroplasty Registry (EPRD). The German versions of the International Classification of Procedures in Medicine (ICPM), the Operation and Procedure Code (OPS) 301 system, and the 10th International Classification of Diseases (ICD-10) were used for registration of diagnosis and procedures. With the exception of procedures performed outside of Germany, this algorithm ensures near perfect tracking of patients insured by these companies. If revision surgeries were performed in a non-participating hospital, a follow-up was performed based on insurance billing data. Data of the two participating health insurance associations (AOK-B, vdek) cover 65% of the German population and are cross-validated by data input of surgeons. The investigation is based on the data set of the German Arthroplasty Registry. (3) Risk factors for the occurrence of aseptic and septic failure of THA should be identified and compared between THA for OA or FNF, and analyzed and compared between THA for the treatment of FNF and OA. ![]() The aim of the present investigation was (1) to report the rate of mortality for THA following primary OA and FNF and (2) to determine the rate of septic and aseptic revisions after treatment of primary OA and FNF with THA. The rates for infections for THA were reported to be around 1% annually following OA and up to 10% following femoral neck fracture. described in a single-center cohort study an increased hazards ratio of 4.3 after FNF compared with osteoarthritis for the development of an infection. The main reasons for required revision surgery are periprosthetic joint infections (PJI), dislocations, periprosthetic fractures, and mechanical loosening. Patients receiving a THA for fracture treatment had a multiple-fold increase in mortality rate, with up to 24% after 1 year. reported a mortality rate after THA for OA of 0.65% (95% CI 0.50–0.81) within the first 90 days. For one thing, THA for the treatment of OA allows patient optimization, while FNF requires timely surgical care, which does not allow optimization of comorbidities and infection-prevention strategies, as is the case in elective joint arthroplasty. Due to the different circumstances, both procedures face different risk profiles. Two of the most common are osteoarthritis (OA) and femoral neck fracture (FNF). Several indications are responsible for the implantation of THA. This corresponds to an annual growth rate of 1.2% and, for some countries, a growth rate of over 125% between 20. Based on historical data provided by Organisation for Economic Co-operation and Development (OECD) countries and a projection analysis, in the year 2050 2.8 (2.6–2.9) million THA will be implanted, while in the year 2015 1.8 million procedures were registered. Total hip arthroplasty (THA) is one of the most commonly performed orthopedic procedures worldwide. ![]()
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