Artroplastia primaria de cadera: resultados en el primer año y factores predictores de mala evolución

Sarasqueta, Cristina; Escobar, Antonio; Arrieta, Y.; Azcárate, J.; Etxebarría-Foronda, I.; González, Inmaculada Fernández; Aizpuru, Felipe; Herrera, Carmen Durán; Linertová, Renata

doi:10.1016/j.recot.2011.09.004

Cited by 4 publications

(12 citation statements)

References 25 publications

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“…Table 1 shows that 14 studies (40 %) had low risk of bias for the follow-up domain. Eight studies [ 14 – 21 ] had a high risk of bias on this domain. One study [ 22 ] had a loss to follow-up of >20 % in the first and third year, but a low loss to follow-up at 5 and 7 years, so that risk of bias was unclear.…”

Section: Resultsmentioning

confidence: 99%

Preoperative predictors for outcomes after total hip replacement in patients with osteoarthritis: a systematic review

Hofstede

Gademan

Vlieland

et al. 2016

BMC Musculoskelet Disord

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BackgroundThis systematic review examines which patient related factors influence functional and clinical outcomes after total hip arthroplasty (THA) in patients with hip osteoarthritis (OA).MethodsWe performed a systematic review according to the PRISMA guidelines. We searched databases and trial registries for prospective studies including OA patients who underwent primary THA. Studies with preoperative measurements on predictors, with at least 1 year follow-up were included. Risk of bias and confounding was assessed for two domains: follow-up rate and looking at independent effects.ResultsThirty-five studies were included (138,039 patients). Only nine studies (29 %) had low risk of bias for all domains thus suggesting an overall low quality of evidence. Studies were heterogeneous in the predictors tested and in the observed directions of the associations. Overall, preoperative function (13 studies (37 %), 2 with low risk of bias) and radiological OA (6 studies (17 %), 1 with low risk of bias) were predictors with the most consistent findings. Worse preoperative function and more severe radiological OA were associated with larger postoperative improvement. However, these patients never reached the level of postoperative functioning as patients with better preoperative function or less severe radiological OA. For age, gender, comorbidity, pain and quality of life the results of studies were conflicting. For BMI, some studies (n = 5, 2 with low risk of bias) found worse outcomes for patients with higher BMI. However, substantial improvement was still achieved regardless of their BMI.ConclusionThere is not enough evidence to draw succinct conclusions on preoperative predictors for postoperative outcome in THA, as results of studies are conflicting and the methodological quality is low. Results suggest to focus on preoperative function and radiological osteoarthritis to decide when THA will be most effective. The present mapping of current evidence on the relationship between patient related factors and outcomes provides better information compared to individual studies and may help to set patient expectations before surgery. In addition, these findings may contribute to discussions on how to achieve the best possible postoperative outcome for specific patient groups.Trial registrationThis systematic review was registered in Prospero, registration number RD42014009977.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1070-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Preoperative predictors for outcomes after total hip replacement in patients with osteoarthritis: a systematic review

Hofstede

Gademan

Vlieland

et al. 2016

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Existen estudios que evidencian que el nivel óptimo de recuperación para las artroplastias está entre 3 y 6 meses, y que el nivel máximo se alcanza al cabo de 1 año (Montagut et al, 2005;Sarasqueta et al, 2012;Escobar et al, 2013). Las expectativas de los pacientes que requieren una prótesis cada vez son mayores, ya que en algunas ocasiones se debe tener en cuenta la necesaria vuelta al trabajo en personas jóvenes.…”

Section: Recomendaciones a Largo Plazounclassified

“…Son importantes los cambios observados en la calidad de vida en áreas relacionadas con el dolor y la capacidad funcional, que se alcanzan principalmente al tercer mes de la intervención; son de menor magnitud los cambios producidos en la salud mental. A la hora de predecir el éxito a largo plazo de la intervención, es importante la situación de partida, especialmente en relación con la función y el estado físico del paciente y la ausencia de complicaciones durante la cirugía o en los primeros 12 meses (Sarasqueta et al, 2012). También Escobar et al (2013) abordan el reemplazo total de rodilla, con el objetivo de proporcionar datos en relación con el dolor y las dimensiones funcionales en un estudio prospectivo multicéntrico con dos cohortes de pacientes, y muestran una mejora importante en estas variables estudiadas al año de la intervención.…”

Section: Recomendaciones a Largo Plazounclassified

“…En el mundo se implantan más de 700.000 prótesis totales y más del 90% de los pacientes logran una función articular satisfactoria durante al menos 10 años, éxito que no solo se debe al alivio del dolor y a la recuperación de la estabilidad y funcionalidad sino también a la restauración de la salud psicosocial (Jones et al, 2003;Rowe et al, 2005;Iborra, 2005;Sarasqueta et al, 2012).…”

Section: Introductionunclassified

“…); generalmente no ofrece complicaciones durante 10-15 años, por lo que son más coste-efectivas que otro tipo de cirugías (Judge et al, 2010;Kauppila et al, 2010;Montin et al, 2011;Lavernia et al, 2011). El impacto positivo también se ha descrito sobre la calidad de vida relacionada con la salud, la integración social, el bienestar psicológico, la sensación somática y la satisfacción con la vida (Sarasqueta et al, 2012).…”

Section: Introductionunclassified

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