Increasing Procedural Volume and Economic Impact of Revision Total Hip Arthroplasty for Hip Instability in the United States

Authors

• Kevin Y. Heo, Emory University School of Medicine, Atlanta, GA
• Joseph D. Lee, Washington State University, Spokane, WA
• Marisa Brito, Emory University School of Medicine, Atlanta, GA
• Vivek Pisharody, Emory University School of Medicine, Atlanta, GA
• Zahra Vafaei Naeini, LSU Health Sciences Center - New OrleansFollow
• Jacob M. Wilson, Emory University School of Medicine, Atlanta, GA
• Ajay Premkumar, Emory University School of Medicine, Atlanta, GA

Document Type

Article

Publication Date

4-10-2026

Publication Title

The Journal of Arthroplasty

Abstract

BACKGROUND: Instability remains one of the most common complications after total hip arthroplasty (THA) and is a notable cause of patient morbidity, pain, and dissatisfaction. Despite advances in implant technology and surgical techniques, the national incidence of instability after THA remains poorly defined. As THA continues to rise, our study aimed to characterize the contemporary volume and economic impact of revision THA (rTHA) for instability in the United States (U.S.). METHODS: There were two national databases that were queried to identify inpatient and outpatient rTHA cases for instability between 2012 and 2022. Exclusion criteria included patients who presented with a periprosthetic joint infection. The national volume of rTHA for instability was calculated, and projected volumes of rTHA for instability were modeled using linear and Poisson regression to 2035. RESULTS: In 2012, there were 9,870 cases of rTHA for instability in the United States, which increased to 16,228 in 2022. By 2035, it is projected that there will be 28,830 cases of rTHA for instability. The average patient costs of rTHA for instability increased from $12,540 to $18,334 from 2012 to 2022. By 2035, patient costs are projected to reach an average of $25,612. The annual cumulative hospital charges increased from $138 million in 2012 to $294 million in 2022. Based on this rate, cumulative hospital charges are expected to increase to $533 million by 2035. CONCLUSIONS: Our study demonstrated that the national volume and economic impact of rTHA for instability continue to rise, with a projected volume approaching 30,000 cases by 2035. Surgeons should be aware of these growing trends, as they emphasize the need for cost-effective care strategies and optimized surgical techniques to mitigate further risks of instability. LEVEL OF EVIDENCE: Level III retrospective cohort.

First Page

1

Last Page

7

PubMed ID

41967529

Rights

© 2026 Elsevier Inc.

Recommended Citation

Heo, Kevin Y.; Lee, Joseph D.; Brito, Marisa; Pisharody, Vivek; Naeini, Zahra Vafaei; Wilson, Jacob M.; and Premkumar, Ajay, "Increasing Procedural Volume and Economic Impact of Revision Total Hip Arthroplasty for Hip Instability in the United States" (2026). School of Medicine Faculty Publications. 4754.
https://digitalscholar.lsuhsc.edu/som_facpubs/4754
10.1016/j.arth.2026.04.016