Cost Analysis of Revision Total Hip Arthroplasty: Influencing Factors and Etiological Impact

Background Total hip arthroplasty (THA) is widely recognized as a landmark surgical procedure of the 20th century, frequently performed due to its favorable outcomes. However, revision hip arthroplasty is more complex, associated with higher complication rates and increased healthcare costs compared to primary procedures. Objective This study aims to analyze the costs associated with revision hip arthroplasty, identify factors influencing these costs, and evaluate the impact of revision etiologies on financial burden. Additionally, it seeks to raise awareness about improving the longevity of primary THA and contribute to the development of a national joint registry. Methods A retrospective analysis was conducted on patients undergoing revision (n = 205) and primary (n = 737) total hip arthroplasty at a single center between 2017–2022. Data including demographics, comorbidities, hospital length of stay, surgical details, complications, and cost information were extracted from hospital records. Statistical analyses were performed to assess differences in cost and clinical variables between groups. Results The median cost for revision THA was significantly higher than for primary THA (15,069.77 TL vs. 8,716.47 TL, p < 0.001). Increased comorbidity burden was associated with higher costs in both groups (p < 0.001). The most common revision indications were aseptic loosening, infection, and periprosthetic fractures, with septic and fracture-related revisions incurring significantly greater costs than aseptic cases. Two-stage revision surgeries were more costly than single-stage procedures (p < 0.001). Additionally, revision cases had longer median hospital stays compared to primary cases (11.5 vs. 3 days, p < 0.001). Conclusions Revision hip arthroplasty imposes substantially greater financial burden than primary procedures, influenced by complications, surgical approach, and revision etiology. Preventive strategies targeting infection reduction and complication minimization are crucial to control escalating costs. With an aging population, the demand for both primary and revision THA is expected to rise, underscoring the need for effective health system planning and cost management strategies.