Patient-Reported Outcomes and Outcome Predictors after Primary Total Hip Arthroplasty: Results from the Dresden Hip Surgery Registry

Haase, Elisabeth; Kopkow, Christian; Beyer, Franziska; Lützner, Jörg; Kirschner, S.; Hartmann, A.; Schmitt, Jochen; Günther, Klaus‐Peter

doi:10.5301/hipint.5000300

Cited by 13 publications

(19 citation statements)

References 22 publications

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“…As a result of this residual disability in some patients, the mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score in the EUROHIP cohort 1 year after total hip replacement was 15% rather than 0%. Other studies have confirmed this variation with positive responder rates for primary total hip replacement from 84% to 93% 1 - 5 . Predictors of worse outcome are older age, low symptom or disability score, high body mass index (BMI), higher number of general comorbidities, musculoskeletal morbidity of major joints and the spine, and depression 3 , 4 , 6 - 17 .…”

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confidence: 73%

The Influence of Arthritis in Other Major Joints and the Spine on the One-Year Outcome of Total Hip Replacement

Huber

Dieppe

Dreinhöfer

et al. 2017

The Journal of Bone and Joint Surgery

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Background:Although arthritis in other affected major joints and back pain are known to lead to worse outcomes following total hip replacement, to our knowledge, these risk factors have not previously been operationalized as a musculoskeletal morbidity profile. The aim of this study was to measure the influence of other major joints and the spine (as grades of musculoskeletal morbidity) on the 1-year outcome of primary total hip replacement.Methods:The EUROHIP study consists of 1,327 patients undergoing primary total hip replacement for arthritis across 20 European orthopaedic centers. The primary outcome was the responder rate at 12 months calculated with the relative effect per patient for total hip replacement using the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The primary predictor of interest was different combinations of arthritis of major joints and the spine grouped into 4 musculoskeletal morbidity grades: 1 (single major joint), 2 (multiple major joints), 3 (single major joint and spine), and 4 (multiple major joints and spine). The confounders adjusted for were age, sex, body mass index, living situation, years of hip pain, American Society of Anesthesiologists (ASA) class, anxiety or depression, and preoperative WOMAC subscales.Results:For this analysis, 845 patients were included with complete 12-month follow-up WOMAC scores. The mean patient age was 65.7 years, and 55.2% of patients were female.Conclusions:The involvement of other major joints and the spine assessed as 1 of 4 musculoskeletal morbidity grades had a strong influence on the 1-year outcome after total hip replacement. The effect size was large compared with other risk factors. Even so, the majority of patients in musculoskeletal morbidity grade 4 had favorable outcomes from the surgical procedure (>74% response to surgical procedures).Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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confidence: 73%

The Influence of Arthritis in Other Major Joints and the Spine on the One-Year Outcome of Total Hip Replacement

Huber

Dieppe

Dreinhöfer

et al. 2017

The Journal of Bone and Joint Surgery

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“…The median postoperative PROM follow-up rate was 70%, and the median number of patients was 2970. Overall, only 8 studies reported preoperative PROMs [11] , [12] , [18] , [19] , [20] , [21] , [22] , [23] , 4 studies did not collect [13] , [17] , [24] , [25] , and 9 studies did not report whether preoperative PROMs were collected [14] , [15] , [16] , [26] , [27] , [28] , [29] , [30] , [31] .…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies reported PROM follow-up rates between 70% and 79%, with a median of 2391 patients (range 1233-97,487) [11] , [12] , [19] , [20] , [21] , [22] , [25] , [26] , [31] , of which 6 studies reported collection of preoperative PROMs [11] , [12] , [19] , [20] , [21] , [22] . Of the 3 studies without preoperative PROM data, 2 did not report whether such data were collected [26] , [31] , and 1 did not collect [25] .…”

Section: Resultsmentioning

confidence: 99%

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Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods

et al. 2019

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Background The use of patient-reported outcome measures (PROMs) has become a mainstay of orthopedic joint arthroplasty research. Large studies with >1000 participants are vital to orthopedic research, as they allow for comprehensive multivariable analysis. Achieving high follow-up rates minimizes potential response bias. Maintaining adequate follow-up rates becomes more challenging as sample size increases. We aimed to systematically review the present literature to determine the follow-up rates of large cohorts/registries of total joint arthroplasty patients and to identify factors associated with successful collection of PROMs. Methods A comprehensive literature search of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were: ≥1000 participants, ≥6 months of postoperative follow-up, and use of validated PROMs postoperatively. Results Of 720 abstracts screened, 21 studies met inclusion criteria. Only 2 studies reported achieving a PROM follow-up rate ≥80%, but neither collected PROMs preoperatively. The median rate of follow-up was 70%, and the median number of patients was 2970. Only 38% (8 of 21) of studies collected baseline PROMs prior to surgery. Conclusions Very few studies in the present literature have collected validated PROMs on ≥1000 patients with ≥80% follow-up; these parameters are conducive to comprehensive multivariable analysis, while maintaining study validity and avoiding follow-up bias. Federal funding and a central coordinating site may be helpful in achieving follow-up in studies of this magnitude. Level of Evidence Level III, systematic review of studies with Level of Evidence I-III.

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“…The majority of procedures are the result of debilitating osteoarthritis that causes daily suffering and reduced function for individuals (Brembo et al 2016). Joint replacement is highly successful in relieving pain and discomfort, permitting a better quality of life to be re-established (Haase et al 2016).…”

Section: Introductionmentioning

confidence: 99%

What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review

Dore-Smith

Killingback

2018

Physical Therapy Reviews

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Background There are an increasing number of people undergoing hip and knee joint replacement each year; approximately 68,000 hip and 76,000 knee replacements respectively are performed in England and Wales. Joint replacements serve to reduce pain and improve function. Objective The purpose of this qualitative literature review is to gain an in depth understanding into participants' postoperative experiences following hip and knee replacement in order to establish if participants can be better supported post joint replacement and whether preoperative education can be enhanced. Method Searches were carried out in 13 online scientific databases (January 1995 to October 2016) to identify relevant studies. The quality of studies was assessed, data were extracted and analysed using thematic synthesis. Results A total of 197 studies were identified and screened against the inclusion/exclusion criteria. Seven studies met the inclusion criteria. Three broad themes were identified; coping with pain, recovering function and the challenges of discharge. In general pain was poorly understood and difficulties arose with the appropriate management postoperatively. The recovery process took commitment and required individuals to have realistic expectations. Participants also felt the need for individualised care as they approached discharge. Conclusion Overall qualitative evidence surrounding postoperative views of participants is limited. It appears current preoperative education does not fulfil the majority of participants' needs. Utilising the views of participants may help to tailor preoperative education or provide alternative support postoperatively. Future research should focus on clarifying the effect of a well constructed and well-delivered pre-operative education sessions.

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Patient-Reported Outcomes and Outcome Predictors after Primary Total Hip Arthroplasty: Results from the Dresden Hip Surgery Registry

Abstract: Treatment with THA leads to improvement in function, decline in pain and increase in quality of life in the vast majority of patients.

Cited by 13 publications

References 22 publications

The Influence of Arthritis in Other Major Joints and the Spine on the One-Year Outcome of Total Hip Replacement

The Influence of Arthritis in Other Major Joints and the Spine on the One-Year Outcome of Total Hip Replacement

Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods

What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review

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