Early Mortality after Modern Total Hip Arthroplasty

Because of improvements in surgical technique, anesthesia, and rehabilitation, mortality after hip arthroplasty may be on the decline. The purpose of this study was to determine the 90-day mortality rate after uncemented total hip arthroplasty (THA) performed under regional anesthesia. We retrospectively reviewed 7478 consecutive patients undergoing cementless primary or revision THA between January 2000 and July 2006. Patient survivorship was established and causes of death were obtained by accessing the Social Security Death Index, Centers for Disease Control and Prevention National Death Index, and State Departments of Vital Statistics. There were two intraoperative deaths from cardiac arrest. The overall 30- and 90-day mortality rates were 0.24% (18 of 7478) and 0.55% (41 of 7478), respectively. Thirty-day mortality after primary THA was low at 0.13% (eight of 6272). The most common cause of death was cardiovascular-related. Mortality after modern THA seems to have remained very low despite the availability of this procedure to patients of all ages and comorbidities.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.