Timothy S. Brown,Samik Banerjee,Robert D. Russell,Michael A. Mont,Michael H. Huo

INTRODUCTION

In the past year, a multitude of research topics have focused on total hip arthroplasty. We focused on the most recent publications from the major orthopaedic journals and on selected abstracts from international meetings that took place during the period encompassing May 2013 through May 2014.

EPIDEMIOLOGY

Kurtz et al. reported that the recent economic downturn in the United States has not slowed the demand for total joint arthroplasty. Current projections estimate that more than 500,000 primary total hip arthroplasties and 65,000 revision total hip arthroplasties will be performed annually by the beginning of the year 2020. With increasing scrutiny on health-care resource allocation, efforts to control health-care spending and improve outcomes are targeting elective surgical procedures such as total hip arthroplasty.

OUTCOMES

Unplanned readmission rates following total hip arthroplasty are 5% to 7.8% for patients after primary total hip arthroplasty, 10% for patients after revision total hip arthroplasty, and 18% for patients after a staged revision for the treatment of periprosthetic joint infection. Surgical site infection (23.2%) and cardiovascular events (16.8%) were the most common diagnoses leading to unplanned readmission in one series. Higher readmission rates were associated with known high-risk medical comorbidities, age, race, male sex, and the need for inpatient sub-acute care following the index admission

Browne et al. reported that 10% of the arthroplasty population in the Nationwide Inpatient Sample database had clinical depression prior to surgery. Depression was correlated to higher early postoperative complications. Obesity has been associated with an increased rate of acetabular cup malposition and an increase in infections. Huang et al., in a prospective collection of nutrition markers in patients undergoing elective total joint arthroplasty at their institution, reported a 12% complication rate in …