International Orthopaedics

, Volume 33, Issue 3, pp 643–651 | Cite as

Trends in mortality, complications, and demographics for primary hip arthroplasty in the United States

  • Spencer S. Liu
  • Alejandro González Della Valle
  • Melanie C. Besculides
  • Licia K. Gaber
  • Stavros G. Memtsoudis
Original Paper


To determine trends in characteristics of total hip arthroplasty (THA) in the United States, the National Hospital Discharge Survey (NHDS) was analyzed from 1990 to 2004 for trends in in-hospital mortality and complications, length of hospital stay, demographics, and comorbidities. The number of THAs performed increased by 158%, whereas mortality rates remained low and slightly decreased (from 0.32% to 0.29%). Prevalence of procedure-related complications decreased over time, and length of stay decreased from an average of 8.7 days to 4.5 days. These improvements occurred despite an increase in comorbidities in patients. An increase in both the proportion of discharges to long- and short-term care facilities and in the proportion of procedures performed in smaller hospitals was noted. Multiple temporal changes in outcomes and demographics for THA were found. These changes have implications for clinical care and allocation of health resources.


Le but de ce travail est de mettre en évidence les nouvelles données caractéristiques des prothèses totales de hanche aux Etats-Unis. Matériel et méthode: Le National Hospital Discharge Survey (NHDS) a été analysé durant la période de 1990 à 2004 sur le plan de la mortalité, des complications, de la durée de séjour, sur le plan démographique et des comorbidités. Résultat: le nombre de prothèses totales de hanche a augmenté de 158% dans cette période alors que la mortalité reste basse et a même légèrement diminué (0,32% à 0,29%). Le taux de complications et la durée moyenne de séjour diminuent également avec le temps de 8,7 jours à 4,5 jours. Ces améliorations entraînent néanmoins une augmentation des comorbidités chez les patients. Il a été noté une augmentation de la proportion des sorties avec prise en charge des soins de courte ou longue durée et une proportion importante de procédures réalisées dans les petits hôpitaux. les modifications notées sur le devenir et sur les bases démographiques des prothèses totales de hanche, ont une implication clinique sur les soins et sur l’allocation de ressource.



This study was performed with funds provided by the Hospital for Special Surgery Young Investigator Award (Dr. Memtsoudis) and by the Department of Anesthesiology, Hospital for Special Surgery. No conflicts of interest arise from any part of this study for any of the authors.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Spencer S. Liu
    • 1
  • Alejandro González Della Valle
    • 2
  • Melanie C. Besculides
    • 3
  • Licia K. Gaber
    • 4
  • Stavros G. Memtsoudis
    • 1
  1. 1.Department of Anesthesiology, Hospital for Special SurgeryWeill Medical College of Cornell UniversityNew YorkUSA
  2. 2.Department of Orthopaedics, Hospital for Special SurgeryWeill Medical College of Cornell UniversityNew YorkUSA
  3. 3.Mathematica Policy Research, Inc.PrincetonUSA
  4. 4.LKG ConsultingPlainsboroUSA

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