ArticleBMJ open2026
Burden and characteristics of revision total hip arthroplasty in China: a national study based on hospitalised cases.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to investigate the burden and characteristics of revision total hip arthroplasty (THA) in China.
designA national retrospective study was conducted based on the Hospital Quality Monitoring System (HQMS) in China. Patients who underwent revision total hip arthroplasty (THA) between 2013 and 2018 were included. Revision burden was calculated as the ratio of revision procedures to the total number of THA procedures. Demographic and hospital characteristics, hospitalisation charges, clinical indications and patient migration patterns related to revision THA were analysed.
settingTertiary hospitals across China.
participantsA total of 13 029 revision THA cases from HQMS. PRIMARY OUTCOME MEASURES: Revision burden, indications for revision, hospitalisation charges, hospital level, patient migration and their trend.
resultsDuring the study period, 13 029 revision THA cases were identified. The revision burden showed an increasing trend from 2013 to 2018 (4.5% to 5.4%; p for trend=0.002). The hospitalisation charges continued to increase between 2013 and 2016 and decreased over the next 2 years. The leading indications for revision THA were prosthesis loosening (44.0%), prosthesis dysfunction (13.7%) and fracture (10.7%). More than 60% of patients were hospitalised in provincial hospitals, but this proportion gradually decreased over time. 14.8% of patients were hospitalised in a hospital outside the province of their residence. Shanghai and Beijing were the most preferred migration destinations, with 63.5% and 52.0% of patients from outside provinces, respectively.
conclusionsThis study provided epidemiological data on revision THA in China based on a national database. During the study period, there was an increasing trend in the revision burden, and hospitalisation costs shifted from an annual increase to a decrease. China exhibits distinct characteristics regarding indications for revision THA. Additionally, significant regional disparities in revision THA were evident, leading to a considerable phenomenon of migration.
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