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I've had two cousins, a brother, and a couple of friends in the last year alone who had to have their first hip replacement removed and replaced with a second one. The cost of this operation was unbelievable. What's happening to cause this problem?

More adults than ever before are having their first hip replacement. And more of those are being done at a younger age. If patients outlive the life of their implant, then revision surgery is needed. Or if there are complications from the first surgery, a revision replacement might be needed. Infection, loosening of the implant, dislocation of the implant, and subsidence (sinking) of the implant into the bone are common reasons why implant failure occurs requiring a second (revision) operation. Costs are also rising. Today's implants can be put in without cement. New surface coatings to make this possible cost more. Hospital and rehab costs have also gone up in the last few years. Some of this can be attributed to inflation. Patients with multiple comorbidities (other health concerns) tend to present as more complex, challenging cases. Longer operating time and more days in the hospital lead to higher costs. The costs for patients who can't be discharge home and must go to an extended-care facility are five-times higher. There are many possible reasons why each of your family members and friends had to have a hip joint revision surgery. It's likely that they each had a different reason. In the future, developing and using evidence-based guidelines for standard of care, patient safety, reducing complications, and managing patient expectations at the time of the surgery. Added together, these steps represent best-practice procedures for both hospitals and specialty centers. The final result might be total decreased costs as a result of reduced hospital length-of-stay, fewer complications, and fewer revision operations.

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