# Observational study exploring the association between sexes and perioperative morbidities after aseptic hip revision arthroplasty

## TL;DR

This study finds that while there are some sex-related differences in specific outcomes after hip revision surgery, overall sex does not significantly affect perioperative risks.

## Contribution

The study provides new insights into sex-specific differences in perioperative outcomes after aseptic hip revision arthroplasty.

## Key findings

- Significant sex differences were found in length of hospital stay, BMI in elderly patients, and surgical complications like delayed wound healing.
- Anemia and transfusion rates were significantly higher in one sex, particularly in elderly patients.
- No general sex differences were observed in systemic complications or overall perioperative risks.

## Abstract

Sex-based analyses in total hip arthroplasty have become increasingly important in understanding the nuanced outcomes and risks associated with this surgical procedure. Recent studies analyzed the complex interplay between sex-specific factors and revision rates, challenging previously held assumptions about sex disparities in hip replacement outcomes. This study examines the correlation between sex and the occurrence of perioperative morbidities after aseptic hip prosthesis revisions.

Data from 261 patients following aseptic revision THA (total hip arthroplasty) were collected. The occurrence of systemic and surgery-related complications during the hospitalisation and in the follow up, the units of blood transfused, and the change in Hb (hemoglobin) were investigated. Hb was collected preoperatively and at 1, 2, and 4 days postoperatively. Analyses of sex differences between different BMI and age groups for perioperative complications and transfusion rates was carried out. The Fischer Exact test and the independent t-test were mainly used for the investigations.

There were significant sex differences in the length of stay (12.10 ± 4.60 vs. 13.90 ± 5.50; p = 0.007, Cohen’s d = 0.344), the BMI in elderly patients (28.30 ± 4.9 vs. 25.80 ± 4.4; p = 0.003; d = 0.553) and occurrence of multiple surgical complications (0.12 ± 0.35 vs. 0.27 ± 0.76; p = 0.024, d = 0.243), esp. delayed wound healing (n = 0 vs. n = 7; p = 0.046, phi = 0.131). Furthermore, occurrence of anemia (n = 9 vs. n = 54; p = < .001, η2 part = 0.092), and transfusion rate in elderly patients were significantly higher (0.20 ± 0.62 vs. 1.06 ± 1.83; p = 0.001, d = 0.642). Significant sex differences were found for surgical complications in the subgroup of BMI (Body-mass-Index) under 30 kg/m2 (0.12 ± 0.373 vs. 0.31 ± .84; Cohen’s d = 0.277; p = 0.027). No sex differences were found for multiple systemic complications (0.11 ± 0.44 vs. 0.13 ± 0.42, p = 0.635).

Although this study found differences in the sex subgroups in terms of age and BMI, no general sex differences between men and women could be identified. When considering perioperative and follow-up risks, sexes do not play a crucial role.

Not applicable