Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)

BMC Musculoskeletal Disorders

David G Lewallen¹  Jasvinder A Singh² 

[1] Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA;Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, AL, USA

关键词: Diagnosis;    Patient-reported outcomes;    Joint replacement;    Arthroplasty;    Total hip replacement;   

Others  :  1130282
DOI  :  10.1186/1471-2474-14-210

 received in 2013-05-20, accepted in 2013-05-21,  发布年份 2013

【 摘 要 】

Background

Little is known about the impact of the reason for revision total hip arthroplasty (THA) on the outcomes following revision THA. In this study, our objective was to assess the association of operative diagnosis with patient-reported outcomes (PROs) after revision THA.

Methods

We used prospectively collected data from the Mayo Clinic Total Joint Registry that collects pre- and post-operative pain and function outcomes using a validated Hip questionnaire, on all revision THAs from 1993–2005. We used logistic regression to assess the odds of moderate-severe index hip pain and moderate-severe limitation in activities of daily living (ADLs) 2- and 5-years after revision THA. We calculated odds ratios (OR) and 95% confidence intervals (CIs).

Results

For the 2- and 5-year cohorts, the operative diagnosis was loosening/wear/osteolysis in 73% and 75%; dislocation/bone or prosthesis fracture/instability or non-union in 17% and 15%; and failed prior arthroplasty with components removed/infection in 11% and 11%, respectively. In multivariable-adjusted analyses that included preoperative ADL limitations, compared to patients with loosening/wear/osteolysis, patients with dislocation/fracture/instability/non-union had OR of 2.2 (95% CI, 1.3-3.5; p = 0.002) for overall moderate-severe ADL limitation and those with failed prior arthroplasty/infection had OR of 1.6 (95% CI, 1.0-2.8; p = 0.06). At 5-years, ORs were lower and differences were no longer significant. Moderate-severe pain did not differ significantly by diagnosis, at 2- or 5-years in multivariable adjusted analyses, with one exception, i.e. failed prior arthroplasty/infection had a trend towards significance with odds ratio of 1.9 (95% CI, 0.9-3.8; p = 0.07).

Conclusions

Operative diagnosis is independently associated with ADL limitations, but not pain, at 2-years after revision THA. Patients should be informed of the risk of poorer short-term outcomes based on their diagnosis.

【 授权许可】

   
2013 Singh and Lewallen; licensee BioMed Central Ltd.

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