STUDY OF DETERMINANTS OF REVISION IN TOTAL HIP REPLACEMENT: IMPACT OF COMORBIDITIES AND SURGEON VOLUME

Background: Total hip replacement (THR) is a widely performed orthopedic procedure for end-stage hip diseases. Despiteadvances in surgical techniques and implant design, revision surgery remains a clinical challenge. The aim is to evaluate thedemographic profile, diagnostic spectrum, and clinical outcomes of patients undergoing THR, with emphasis on factorsinfluencing revision surgery. Materials and Methods: A prospective observational study was conducted on 80 patients aged20–60 years undergoing primary THR. Demographic variables, diagnostic type, comorbidity status, and surgeon casevolume were analyzed. Surgical procedures were performed using standard posterior or lateral approaches, with cemented oruncemented fixation as required. Statistical analysis was carried out using chi-square tests, with p < 0.05 consideredsignificant. Results: The majority of patients were aged 41–50 years (40%) and 51–60 years (40%), with a slight malepredominance (55%). Osteoarthritis secondary to avascular necrosis (AVN) was the leading indication (50%), followed byinflammatory arthritis (16%), post-traumatic osteoarthritis (10%), and post-infectious sequelae (10%). Revision surgery wasrequired in 5% of cases, with no significant association with age or gender. However, patients with comorbidities had asignificantly higher revision rate (25% vs. 1.5%, p = 0.0005). Surgeon volume also influenced outcomes, with lower-volumesurgeons (≤60/year) associated with higher revision rates (15% vs. 1.7%, p = 0.017). Conclusion: While demographicfactors such as age and gender did not significantly affect revision rates, comorbidities and surgeon experience were criticaldeterminants of outcome. Optimizing patient health and concentrating procedures in high-volume centers are essentialstrategies to reduce revision rates and improve long-term success in total hip replacement.