Predictors of excellent early outcome after total hip arthroplasty

Journal of Orthopaedic Surgery and Research

Ivan J Brenkel¹  Edward Dunstan¹  James A Ballantyne¹  Simon Johnson¹  George H Smith¹ 

[1] Department of Trauma and Orthopaedics, Queen Margaret Hospital, Dunfermline, KY12 0SU Scotland, UK

关键词: predictors;    Total hip Arthroplasty;    Outcome;    Excellent;   

Others  :  817955
DOI  :  10.1186/1749-799X-7-13

 received in 2011-07-09, accepted in 2012-03-25,  发布年份 2012

【 摘 要 】

Background

Not all patients gain the same degree of improvement from total hip replacement and the reasons for this are not clear. Many investigators have assessed predictors of general outcome after hip surgery. This study is unique in its quest for the predictors of the best possible early outcome.

Methods

We prospectively collected data on 1318 total hip replacements. Prior to surgery patient characteristics, demographics and co-morbidities were documented. Hip function and general health was assessed using the Harris Hip score (HHS) and the Short-Form 36 respectively. The HHS was repeated at three years. We took a maximal HHS of 100 to represent an excellent outcome (102 patients). Multiple logistic regression analysis was used to identify independent predictors of excellent outcome.

Results

The two strongest predictive factors in achieving an excellent result were young age and a high pre-operative HHS (p = 0.001).

Conclusions

It was the young and those less disabled from their arthritis that excelled at three years. When making a decision about the timing of hip arthroplasty surgery it is important to take into account the age and pre-operative function of the patient. Whether these patients continue to excel however will be the basis of future research.

【 授权许可】

   
2012 Smith et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ng CY, Ballantyne JA, Brenkel IJ: Quality of life and functional outcome after total hip repacement. A five-year follow-up. J Bone Joint Surg Br 2007, 89(7):868-873.
• [2]Räsänen P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynänen OP, Roine RP: Effectiveness of hip or knee replacement surgery in terms of quality-adjusted years and costs. Acta Orthop 2007, 78(1):108-115.
• [3]Nilsdotter A-K, Petersson IF, Roos EM, Lohmander LS: Predictors of patient relevant outcome after total hip replacement for osteoarthritis: a prospective study. Ann Rheum Dis 2003, 62:923-930.
• [4]Johanson NA, Abzug JM, Gallus CA, Charlson ME: Baseline function and comorbidity predict outcome in total hip arthroplasty. UPOJ 2009., 194
• [5]Davis AM, Agnidis Z, Bradley E, Kiss A, Waddell JP, Gross AE: Predictors of functional outcome two years following revision hip arthroplasty. J Bone Joint Surg Am 2006, 88-A:685-691.
• [6]Cushnaghan J, Coggon D, Reading I, Croft P, Byng P, Cox K, Dieppe P, Cooper C: Long-term outcome following total hip arthroplasty: A controlled longitudinal study. Arthritis Rheum 2007, 57(8):1375-1380.
• [7]Biring GS, Masri BA, Greidanus NV, Duncan CP, Garbuz DS: Predictors of quality of life outcomes after revision total hip replacement. J Bone Joint Surg Br 2007, 89-B(11):1446-1451.
• [8]Harris WH: Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969, 51:737-755.
• [9]British Orthopaedic Association: Total Hip Replacement. A guide to best practice. London: BOA; 2009.
• [10]Field RE, Cronin MD, Singh PJ: The Oxford hip scores for primary and revision hip replacement. J Bone Joint Surg Br 2005, 87-B(5):618-622.
• [11]Fortin PR, Penrod JR, Clarke AE, St-Pierre Y, Joseph L, Belisle P, Liang MH, Ferland D, Phillips CB, Mahomed N, Tanzer M, Sledge C, Fossel AH, Katz JN: Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee. Arthritis Rheum 2002, 46(12):3327-3330.
• [12]Lingard EA, Katz JN, Wright EA, Sledge CB: Kinemax Outcomes Group. Predicting the outcome of total knee arthroplasty. J Bone Joint Surg Am 2004, 86-A:2179-2186.
• [13]Röder C, Staub LP, Eggli S, Dietrich D, Busato A, Müller U: Patients with poor preoperative walking capacity and hip flexion are less likely to achieve an optimal outcome with regard to walking and motion. J Bone Joint Surg Am 2007, 89:11-17.
• [14]Marchetti P, Binazzi R, Vaccari V, Girolami M, Norici F, Impallomeni C, Commessatti M, Silvello L: Long-term results with cementless Fitek (or Fitmore) cups. J Arthroplasty 2005, 20(6):730-737.
• [15]Hoeksma HL, Van den Ende Ronday , Heering A, Breedveld FC, Dekker J: Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip. Ann Rheum Dis 2003, 62:935-938.
• [16]Soderman P, Malchau H: Is the Harris hip score system useful to study the outcome of total hip replacement? Clin Orthop Relat Res 2001, 384:189-97.
• [17]Rothwell PM, McDowell Z, Wong CK, Dorman PJ: Doctors and patients don't agree: cross sectional study of patients' and doctors' perceptions and assessments of disability in multiple sclerosis. BMJ 1997, 314:1580-1583.
• [18]Hilmarsson S, Soderman P, Herbert P, Malchau H: An epidemiological analysis of a young total hip replacement population in Sweden. J Bone Joint Surg Br 2006, 88-B:S1. 47-48
• [19]Callaghan JJ, Forest EE, Olejniczak JP, Goetz DD, Johnston RC: Charnley total hip arthroplasty in patients less than fifty years old: A twenty to twenty-five year follow-up note. J Bone Joint Surg Am 1998, 80:704-714.
• [20]Brenkel IJ, Elson DW: Prediction of poor pain outcomes in total knee arthroplasty. J Bone Joint Surg Br 2005, 88-B(SI):28.
• [21]MacWilliam CH, Yood MU, Verner JJ, McCarthy BD, Ward RE: Patient-related risk factors that predict poor outcome after total hip replacement. Health Serv Res 1996, 31(5):623-638.