Septic Hip Revision Arthroplasty—A Perioperative and Follow-Up Risk Analysis

<b>Background:</b> Septic hip revision arthroplasty is a complex procedure associated with significant perioperative risks. This study aimed to analyze perioperative and follow-up risk factors in patients undergoing septic hip revision arthroplasty. <b>Methods:</b> A retrospective analysis was conducted on 96 patients who underwent septic revision total hip arthroplasty between 2018 and 2021 at a university hospital. Demographic data, surgical details, pathogen analyses, and complication data were collected and analyzed. The first and second hospitalizations were investigated. Data analyses were conducted with SPSS Version 29.0. <b>Results:</b> The mean age of patients was 69.06 ± 11.56 years, with 59.4% being female. On average, 1.3 ± 0.8 pathogens were detected per patient. <i>Staphylococcus</i> species were the most common pathogens. Women experienced significantly more complications during the first revision hospitalization (<i>p</i> = 0.010), including more surgical (<i>p</i> = 0.022) and systemic complications (<i>p</i> = 0.001). Anemia requiring transfusion was more common in women (70.1% vs. 43.5%, <i>p</i> = 0.012). A higher BMI was associated with a higher count of pathogens (<i>p</i> = 0.019). The number of pathogens correlated with increased wound healing disorders (<i>p</i> < 0.001) and the need for further revision surgeries (<i>p</i> < 0.001). <b>Conclusions:</b> This study identifies gender as a significant risk factor for complications in septic hip revision arthroplasty. Female patients may require more intensive perioperative management to mitigate risks. The findings underscore the need for personalized approaches in managing these complex cases to improve outcomes.