JOA - 2026-07-24 - Journal Article
National Case Volume and Economic Burden of Inpatient Revision Hip Arthroplasty for Aseptic Loosening: Trends and Future Projections from 2012 to 2032.
Pisharody VA, Nour G, Chowdary AR, Ross B, Erens GA, Wilson JM, Premkumar A
Topics
Key Takeaway
Inflation-adjusted cost per inpatient revision THA for aseptic loosening rose from $28,810 in 2012 to $31,461 in 2022 and is projected to reach $36,424 by 2032, while annual case volume declined from 11,070 to 9,650 pre-pandemic and collapsed to 5,894 in 2021.
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Summary
This study queried a nationally representative weighted hospital admissions database to characterize annual incidence and inpatient costs of revision THA for aseptic loosening from 2012 to 2022, with projections to 2032. Pre-pandemic annual volumes declined modestly from 11,070 (2012) to 9,650 (2019), then fell sharply to 5,894 in 2021. Inflation-adjusted cost per admission rose 9.2% over the study period and is projected to increase an additional 15.8% by 2032.
Key Limitation
Post-pandemic volume data through 2022 remain depressed and may reflect deferred care rather than a true secular decline, making 2032 projections based on this trend potentially unreliable.
Original Abstract
INTRODUCTION
Aseptic loosening after hip arthroplasty is a major complication often necessitating revision procedures. Revision hip arthroplasty is associated with major morbidity and healthcare expenditure, but the national volumes and associated economic burden of revision hip arthroplasty for aseptic loosening have not been characterized. In this study, we estimated the nationwide annual incidence and average costs of inpatient revision arthroplasty for prosthetic loosening and projected future costs.
METHODS
A nationally representative weighted database of hospital admissions was queried to identify admissions for inpatient revision hip arthroplasty in the setting of aseptic loosening. The national annual incidence of such admissions and associated inpatient costs were estimated. The average cost results were then projected to the year 2032. Costs were adjusted for inflation to 2022 United States dollars using Consumer Price Index data.
RESULTS
In the pre-pandemic period, national annual incidence gradually declined, ranging between 11,070 in 2012 and 9,650 in 2019. Inpatient volumes fell in the pandemic period to a low of 5,894 in 2021. The inflation-adjusted average cost per admission increased from $28,810 in 2012 to $31,461 in 2022. National total costs fell from $318,924,352 in 2012 to $296,561,705 in 2019 and a pandemic low of $198,713,285 in 2021. Inflation-adjusted costs per admission were projected to rise to $36,424 by 2032.
CONCLUSIONS
The national average cost per admission for revision hip arthroplasty for prosthetic loosening has increased since 2012. Inpatient revision volumes decreased in the pandemic period and remained depressed into 2022, the final year for which data are available. Projections suggest that while total nationwide costs may fall, costs per admission will continue to rise, potentially posing a challenge for policymakers, insurers, and orthopaedic surgeons in the coming years.