Total Hip Arthroplasty Revision Rates | PCOM Research 2023
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Total Hip Arthroplasty Revision Rates 
January Research Highlights

January 31, 2023
PCOM medical student David Cieremans, MS, smiling in a suit.
PCOM medical student David Cieremans, MS

There is good news for today's growing number of younger hip replacement patients. Their implants are built to last, according to a study presented at the 2023 Annual Meeting of the American Academy of Orthopaedic Surgeons that found that total hip arthroplasty (THA) patients under 65 have exceedingly low revision rates at eight years post-surgery. Using data from the American Joint Replacement Registry (AJRR), researchers, led by the study's lead author, PCOM medical student David Cieremans, MS (DO '24), found that only 1% of sampled patients needed revision surgery for THA within an eight-year period.

“When a young and active patient is exploring THA, it's important for their surgeon to understand the expected lifespan of the implant to help make informed decisions,” says Cieremans, who was recently named PCOM’s Student Researcher of the Year.

Historically, younger total hip replacement patients have had poor long-term outcomes associated with implant failure, most commonly due to component loosening, polyethylene wear, instability and infection, notes Cieremans. But as surgical techniques and implant designs have improved over the past 15 years, the researchers sought to determine if the same could be said for outcomes and implant longevity.

In the study, “Trends in Complications and Outcomes in Patients Aged 65 and Younger Undergoing Total Hip Arthroplasty: Data from the American Joint Replacement Registry,” the team used the registry's database to identify all THA procedures performed from 2012 through 2020 in patients aged 18 to 65. The study measured primary outcomes including cumulative revision rate, 90-day readmission rate and reason for revision. In total, 5,153 patients were included in the analysis with an average age of 56.7 years ± 7.8 years. Mean follow up was 39.57 months.

David Cieremans, MS, standing with his research poster on total hip arthroplasty at the AAOS conference.
David Cieremans, MS, stands in front of his poster at the American Academy of Orthopaedic Surgeons conference.

Results of the study included:

  • Fifty-three patients (1%) underwent revision during the study period, and 74 patients (1.4%) were readmitted within 90 days.
  • The most common causes for revision were infection (20.8%), instability (15.1%), periprosthetic fracture (13.2%) and aseptic loosening (9.4%).
  • The most common reasons for 90-day readmission without revision were infection (22.9%), pain (9.5%) and periprosthetic fracture (5.4%).

The results of this study are important as the demand for total hip replacements is expected to increase 174% from 2005 to 2030, and 28% of the 572,000 THA procedures performed annually are in patients under the age of 55, notes Cieremans.

“As we conduct further research on these patients over the next few years,” says Cieremans, “we'll be able to continue to inform treatment decisions and outcomes including the average lifespan of the implants beyond eight years.”

January 2023 Research Highlights at PCOM

Faculty, staff and students at the College's three locations frequently participate in innovative research studies in a variety of topics including youth anxiety, e-sports injuries and much more. The overall goal of PCOM research is to develop and test novel approaches to diagnosing, treating and preventing dysfunction and disease.

View more PCOM research highlights for the month of January:

Samantha Baker, MS, (PsyD '23) co-authored “CBT for Youth Anxiety: How Does It Fit Within Community Mental Health?” published in Current Psychiatry Reports.

Sean Cleary (DO '24) co-authored “The two sRNAs OmrA and OmrB indirectly repress transcription from the LEE1 promoter of enteropathogenic Escherichia coli,” published in Folia Microbiologica.

Eric Cyphers (DO '24) co-authored “Required Suspension of DNR/DNI Orders in Interventional Radiology: a Survey of Prevalence and Practices,” published in the Journal of Vascular and Interventional Radiology and “Special Communication: Looking Back on the Birth and Early Days of Interventional Radiology: Reflections of Dr. Stanley Baum,” published in Seminars in Interventional Radiology.

Salvador A. Forte, DO, (RES), a resident in the department of orthopedic surgery, co-authored “One and a Half-Stage Revision With Prosthetic Articulating Spacer for Definitive Management of Knee Periprosthetic Joint Infection,” published in Arthroplasty Today

Alicia Hahn-Murphy, MS, assistant director of diversity and community relations, and Marcine Pickron-Davis, PhD, chief diversity and community relations officer, co-facilitated a workshop, “Navigating Microaggression in the Workplace,” for the Pennsylvania Diversity Council.

Jazmone Kelly (DO '23) co-authored “Treatment of Open Traumatic Medial Malleolus Bone Loss with Osteochondral Allograft: A Case Report,” published in Cureus.

Moon Young Lee (DO '23) co-authored “A Case of Olanzapine-Induced Neutropenia,” published in the Journal of the Academy of Consultation-Liaison Psychiatry as well as “Psychotropic-Induced Priapism: A Case Report of Recurrent Antipsychotic-Induced Priapism and Review of the Literature,” published in the Journal of the Academy of Consultation-Liaison Psychiatry.

Adam Lencer (DO '23) co-authored “Analysis of Musculoskeletal Injuries Among Collegiate Varsity Electronic Sports Athletes,” published in Cureus.

Mohammad Malik (DO '24) co-authored “Anomalous Origin of the Right Coronary Artery From the Left Coronary Cusp Presenting as a Non-ST-Elevation Myocardial Infarction (NSTEMI),” published in Cureus.

Alexandra McQuillen (DO '25) co-authored “Implementation of Robotic Surgery in a Rural Setting: Impact on Need for Assistant Surgeon and Route of Hysterectomy,” published in the Journal of Minimally Invasive Gynecology.

Drew Nagele, PsyD, clinical professor, psychology, co-authored “Caregiver and Student Perspectives on School Services for Students With TBI During the COVID-19 Pandemic,” published in The Journal of Head Trauma Rehabilitation. He also co-authored “Social, Health, and Academic Performance of Children With TBI Engaged in a Formal Return-to-School Support Program,” published in The Journal of Head Trauma Rehabilitation.

Sara Reece, PharmD, vice chair and associate professor, PCOM Georgia School of Pharmacy, co-authored “Diabetes technology: A primer highlighting the role of the pharmacist,” published in the Journal of the American College of Clinical Pharmacy.

Hifza Sakhi (DO '24) co-authored “Graph-based Fusion Modeling and Explanation for Disease Trajectory Prediction,” published in medRxiv.

Kalkaew Sukniam (DO '24) co-authored “Disparities in Time to Treatment for Breast Cancer,” published in Anticancer Research.

Reddhyia Taylor (DO '23) co-authored “Comparison of Retinal Imaging Techniques in Individuals with Pulmonary Artery Hypertension Using Vessel Generation Analysis,” published in Life (Basel).

Ivanna Ward (DO '24) co-authored “Nonatopic Eosinophilic Esophagitis in an Adult,” published in Cureus.

Kevin Wojcik, DO '18, (RES), a neurosurgery resident at Cooper University Hospital, co-authored “Comparison of 4-factor prothrombin complex concentrate and andexanet alfa for reversal of apixaban and rivaroxaban in the setting of intracranial hemorrhage,” published in the Journal of Thrombosis and Thrombolysis.

Dianzheng Zhang, PhD, professor of biochemistry and molecular biology, co-authored “Regulation, targets and functions of CHK,” published in Frontiers in Cell and Developmental Biology.

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