Long-term Cumulative Incidence and Indications for Revision Total Hip Arthroplasty among Patients with Celiac Disease: A Retrospective Cohort Analysis

Aim and background: Malabsorptive conditions, including celiac disease (CD), have been linked to higher rates of early postoperative medical and surgical complications after total hip arthroplasty (THA).However, the long-term consequences of CD on outcomes following THA remain poorly characterized.Thus, this study aimed to evaluate the 10-year cumulative incidence of revision THA and the underlying indications for revision among patients living with CD. Materials and methods: A retrospective cohort analysis was performed using a large national administrative claims database.Patients diagnosed with CD were propensity-matched to control for age, biological sex, and the Charlson Comorbidity Index (CCI). Results:The study cohort included 2,778 patients with CD (20.1%) and 11,038 matched controls (79.9%).At 10 years following THA, the cumulative incidence of all-cause revision was 3.5% among patients with CD and 3.9% among control patients.No statistically significant differences were observed between the cohorts with respect to rates of mechanical loosening, all-cause revision, periprosthetic joint infection (PJI), and periprosthetic fracture (PPF). Conclusion:Patients with CD demonstrated revision and complication rates comparable to those of matched controls following THA.These findings suggest that the mechanisms influencing long-term revision risk in this population are likely complex and multifactorial.Further research should be conducted to better understand the long-term outcomes following THA for malabsorptive conditions.Clinical significance: Celiac disease alone should not be considered a contraindication to THA nor a predictor of long-term implant failure.