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Gupta VK, Hoskins WT, Frampton CMA, Vince KG. No Difference in Revision Rates or Patient-Reported Outcome Measures Between Surgical Approaches for Total Hip Arthroplasty Performed for Femoral Neck Fracture: An Analysis of 5,025 Primary Total Hip Arthroplasties From the New Zealand Joint Registry. J Arthroplasty 2024; 39:2767-2773. [PMID: 38710344 DOI: 10.1016/j.arth.2024.04.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) for femoral neck fracture (FNF) can be performed through different surgical approaches. This study compared the revision rates and patient-reported outcome measures by surgical approach. METHODS Data from the New Zealand Joint Registry were analyzed for patients undergoing primary THA for FNF from January 2000 to December 2021. A total of 5,025 THAs were performed for FNF; the lateral approach was used in 2,499 (49.7%), the posterior in 2,255 (44.9%), and the anterior in 271 (4.3%). The primary outcome measure was the all-cause revision rate. Secondary outcome measures included revision rates for: dislocation, aseptic femoral component loosening, periprosthetic fracture, and infection. Oxford Hip Scores (OHS) were also collected. Age, sex, body mass index, American Society of Anesthesiologists score, femoral head size, dual mobility use, femoral fixation, and surgeon experience were assessed as potential confounding variables. RESULTS There was no difference in the revision rates between lateral and posterior (P = .156), lateral and anterior (P = .680), or posterior and anterior (P = .714) approaches. There was no difference in the reasons for revision between the lateral and posterior approaches or 6-month OHS (P = .712). There was insufficient data to compare the anterior approach. CONCLUSIONS There is no difference in the overall revision rates, reasons for revision, or OHS between the lateral and posterior surgical approaches for THA performed for FNF. Insufficient data on the anterior approach is available for an accurate comparison. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Vikesh K Gupta
- Department of Orthopaedic Surgery, Christchurch Public Hospital, Christchurch, New Zealand; Department of Orthopaedic Surgery, Whangarei Base Hospital, Whangarei, New Zealand
| | - Wayne T Hoskins
- Department of Orthopaedic Surgery, Whangarei Base Hospital, Whangarei, New Zealand; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; Traumaplasty Melbourne, East Melbourne, Australia
| | | | - Kelly G Vince
- Department of Orthopaedic Surgery, Whangarei Base Hospital, Whangarei, New Zealand
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Iljazi A, Sørensen MS, Winther-Jensen M, Overgaard S, Petersen MM. Discontinuing the recommendation of hip precautions does not increase the risk of early dislocation after primary total hip arthroplasty using 36-mm heads: a population-based study from the Danish Hip Arthroplasty Register. Acta Orthop 2024; 95:407-414. [PMID: 39023400 PMCID: PMC11257070 DOI: 10.2340/17453674.2024.41168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/03/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND AND PURPOSE Dislocation is a severe complication following total hip arthroplasty (THA). Hip precautions have been recommended in the initial postoperative period but evidence supporting this practice is limited. We therefore conducted a population-based study to evaluate the association between discontinuing recommending postoperative hip precautions and the risk of early dislocation. METHODS This is a cohort study with data from the Danish Hip Arthroplasty Register and the Danish National Patient Register. We included patients who underwent primary THA for osteoarthritis in 2004-2019 in public hospitals in the Capital Region of Denmark. The cohort was divided into the hip precautions group, comprising patients operated on between 2004 and 2009, and the no-precautions group operated on between 2014 and 2019. The primary outcome was the difference in the absolute risk of dislocation within 3 months post-surgery. The secondary outcome assessed the same risk within 2 years. We evaluated the difference in absolute risk using absolute risk regression (ARR). RESULTS The cumulative incidence of dislocation within 3 months was 2.9% (confidence interval [CI] 2.5-3.3) in the hip precautions group and 3.5% (CI 3.1-3.9) in the no-precautions group. The risk of dislocation was higher in the no-precautions group but failed to reach statistical significance in the crude (ARR 1.2, CI 0.9-1.6) and multivariate model (ARR 1.4, CI 0.9-2.2). CONCLUSION We found a higher but statistically insignificant increase in the risk of early dislocation in the no-precautions group. The lack of significance in the association may be explained by the increased use of 36-mm femoral heads after the guideline revision.
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Affiliation(s)
- Afrim Iljazi
- Department of Orthopedic Surgery, Copenhagen University Hospital Rigshospitalet.
| | - Michala Skovlund Sørensen
- Department of Orthopedic Surgery, Copenhagen University Hospital Rigshospitalet; Department of Orthopedic Surgery, Zealand University Hospital; Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
| | - Matilde Winther-Jensen
- Department of Data, Biostatistics and Pharmacoepidemiology, Centre for Clinical Research and Prevention, Copenhagen University Hospital Bispebjerg-Frederiksberg
| | - Søren Overgaard
- Department of Orthopedic Surgery and Traumatology, Copenhagen University Hospital Bispebjerg-Frederiksberg; Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
| | - Michael Mørk Petersen
- Department of Orthopedic Surgery, Copenhagen University Hospital Rigshospitalet; Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
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Hermansen LL, Iversen TF, Iversen P, Viberg B, Overgaard S. The "true" 1-year incidence of dislocation after primary total hip arthroplasty: validation of an algorithm identifying dislocations in the Danish National Patient Register based on 5,415 patients from the Danish Hip Arthroplasty Register. Acta Orthop 2024; 95:380-385. [PMID: 39016045 PMCID: PMC11253031 DOI: 10.2340/17453674.2024.41064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 06/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND AND PURPOSE Dislocations continue to be a serious complication after primary total hip arthroplasty (THA). Our primary aim was to report the "true" incidence of dislocations in Denmark and secondarily to validate a previously developed algorithm designed to identify THA dislocations in the updated version of the Danish National Patient Register (DNPR), based on data from the Danish Hip Arthroplasty Register (DHR). METHODS We included 5,415 primary THAs from the DHR performed from July 1 to December 31, 2019. Version 3 of the DNPR was launched in February 2019, and a combination of data from the DNPR and a comprehensive national review of 1,762 hospital contacts enabled us to identify every dislocation occurring during the 1st year after THA to determine the "true" 1-year incidence of dislocation. The results were presented as proportions with 95% confidence intervals (CI), and validation was performed by calculating sensitivity and predictive values. RESULTS The "true" 1-year incidence of dislocation was 2.8% (CI 2.4-3.3). Of these, 37% suffered recurrent dislocations during the follow-up period. Between-hospital variation ranged from 0.0% to 9.6%. The algorithm demonstrated a sensitivity close to 95%, while maintaining a positive predictive value of above 94%. CONCLUSION The "true" 1-year incidence of dislocation of 2.8% is comparable to earlier findings, and large variation among hospitals continues to be evident. We have proven the algorithm to be valid in the latest DNPR (version 3), enabling it to be employed as a new quality indicator in future annual DHR reports.
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Affiliation(s)
- Lars L Hermansen
- Department of Orthopedics, University Hospital of Southern Denmark, Esbjerg; Department of Regional Health Research, University of Southern Denmark, Odense.
| | | | - Pernille Iversen
- The Danish Clinical Quality Program and Clinical Registries (RKKP)
| | - Bjarke Viberg
- Department of Orthopedics and Traumatology, Odense University Hospital, Odense; Department of Clinical Research, University of Southern Denmark, Odense
| | - Søren Overgaard
- Department of Orthopedic Surgery and Traumatology, Bispebjerg Hospital; Department of Clinical Research, University of Copenhagen, Denmark
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Olesen BA, Närhi SF, Jensen TG, Overgaard S, Palm H, Sørensen MS. Incidence of dislocation and associated risk factors in patients with a femoral neck fracture operated with an uncemented hemiarthroplasty. BMC Musculoskelet Disord 2024; 25:119. [PMID: 38336702 PMCID: PMC10854108 DOI: 10.1186/s12891-024-07237-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Several factors might be associated with risk of dislocating following uncemented hemiarthroplasty (HA) due to femoral neck fracture (FNF). Current evidence is limited with great variance in reported incidence of dislocation (1-15%). Aim of this study was to identify the cumulative incidence of first-time dislocation following HA and to identify the associated risk factors. METHOD We performed a retrospective cohort study of patients receiving an HA (BFX Biomet stem, posterior approach) at Copenhagen University Hospital, Bispebjerg, in 2010-2016. Patients were followed until death or end of study (dec 2018). Dislocation was identified by code extraction from the Danish National Patient Registry. Variables included in the multivariate model were defined pre-analysis to include: age, sex and variables with a p-value < 0.1 in univariate analysis. A regression model was fitted for 90 days dislocation as the assumption of proportional hazard rate (HR) was not met here after. RESULTS We identified 772 stems (some patients occurred with both right and left hip) and 58 stems suffered 90 dislocations during the observation period, resulting in a 7% (CI 5-9) incidence of dislocation 90 days after index surgery. 55 of the 58 stems (95%) experienced the first dislocation within 90 days after surgery. Only absence of dementia was identified as an independent protective factor in the cause-specific model (HR 0.46 (CI 0.23-0.89)) resulting in a 2.4-fold cumulative risk of experiencing a dislocation in case of dementia. Several other variables such as age, sex, various medical conditions, surgery delay and surgical experience were eliminated as statistical risk factors. We found a decrease in survival probability for patients who experienced a dislocation during follow-up. CONCLUSIONS The incidence of first-time dislocation of HA (BFX Biomet stem, posterior approach) in patients with a hip fracture is found to be 7% 90 days after surgery. Due to the non-existing attribution bias, we claim it to be the true incidence. Dementia was among several variables identified as the only risk factor for dislocation. In perspective, we may consider treating patients with dementia by other methods than HA e.g., HA with cement or with a more constrained solution. Also, a surgical approach that reduce the risk of dislocation should be considered.
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Affiliation(s)
- Britt Aaen Olesen
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark.
| | - Susanne Faurholt Närhi
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark
| | - Thomas Giver Jensen
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Henrik Palm
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark
| | - Michala Skovlund Sørensen
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 5, Staircase 6, 2. Floor, Copenhagen, NV, 2400, Denmark
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Cnudde PHJ, Nåtman J, Rolfson O, Hailer NP. The True Dislocation Incidence following Elective Total Hip Replacement in Sweden: How Does It Relate to the Revision Rate? J Clin Med 2024; 13:598. [PMID: 38276104 PMCID: PMC10816596 DOI: 10.3390/jcm13020598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: The true dislocation incidence following THA is difficult to ascertain in population-based cohorts. In this study, we explored the cumulative dislocation incidence (CDI), the relationship between the incidence of dislocation and revision surgery, patient- and surgery-related factors in patients dislocating once or multiple times, and differences between patients being revised for dislocation or not. (2) Methods: We designed an observational longitudinal cohort study linking registers. All patients with a full dataset who underwent an elective unilateral THA between 1999 and 2014 were included. The CDI and the time from the index THA to the first dislocation or to revision were estimated using the Kaplan-Meier (KM) method, giving cumulative dislocation and revision incidences at different time points. (3) Results: 136,810 patients undergoing elective unilateral THA were available for the analysis. The 30-day CDI was estimated at 0.9% (0.9-1.0). The revision rate for dislocation throughout the study period remained much lower. A total of 51.2% (CI 49.6-52.8) suffered a further dislocation within 1 year. Only 10.9% of the patients with a dislocation within the first year postoperatively underwent a revision for dislocation. (4) Discussion: The CDI after elective THA was expectedly considerably higher than the revision incidence. Further studies investigating differences between single and multiple dislocators and the criteria by which patients are offered revision surgery following dislocation are urgently needed.
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Affiliation(s)
- Peter H. J. Cnudde
- Swedish Arthroplasty Register, Registercentrum Västra Götaland, 413 45 Gothenburg, Sweden; (J.N.); (O.R.); (N.P.H.)
- School of Management, Swansea University, Bay Campus, Swansea SA1 8EN, UK
- Department of Orthopaedics, Hywel Dda University Healthboard, Prince Philip Hospital, Bryngwynmawr, Llanelli SA14 8QF, UK
- Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Göteborgsvägen 37, 431 80 Mölndal, Sweden
| | - Jonatan Nåtman
- Swedish Arthroplasty Register, Registercentrum Västra Götaland, 413 45 Gothenburg, Sweden; (J.N.); (O.R.); (N.P.H.)
| | - Ola Rolfson
- Swedish Arthroplasty Register, Registercentrum Västra Götaland, 413 45 Gothenburg, Sweden; (J.N.); (O.R.); (N.P.H.)
- Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Göteborgsvägen 37, 431 80 Mölndal, Sweden
| | - Nils P. Hailer
- Swedish Arthroplasty Register, Registercentrum Västra Götaland, 413 45 Gothenburg, Sweden; (J.N.); (O.R.); (N.P.H.)
- Orthopaedics, Department of Surgical Sciences, Uppsala University, Akademiska Sjukhuset, Ingång 61, 751 85 Uppsala, Sweden
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Krumme JW, Bonanni S, Patel NK, Golladay GJ. Technical Considerations and Avoiding Complications in Total Hip Arthroplasty. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202211000-00011. [PMID: 36733988 PMCID: PMC9668563 DOI: 10.5435/jaaosglobal-d-22-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 09/25/2022] [Indexed: 11/22/2022]
Abstract
Total hip arthroplasty (THA) is considered to be the surgical procedure of the 20th century. Current projections show that by 2030, primary THA is expected to grow by 171%, with revision THA expected to increase by 142% in the same time frame. Although complications are not common, when they occur, they can cause notable morbidity to the patient. Understanding the unique anatomy and needs of each patient will prepare the surgeon to avoid soft-tissue or bony injury, optimize prosthesis placement, and decrease the risk of infection. This article aims to highlight common causes of early revision THA and provide specific technical strategies to avoid these complications. Following a systematic approach to the primary THA and using these techniques will assist the surgeon in avoiding complications to revision hip arthroplasty.
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Affiliation(s)
- John W. Krumme
- From the Department of Orthopaedic Surgery, University of Missouri–Kansas City, Kansas City, MO (Dr. Krumme and Dr. Bonanni), and the Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA (Dr. Patel and Dr. Golladay)
| | - Sean Bonanni
- From the Department of Orthopaedic Surgery, University of Missouri–Kansas City, Kansas City, MO (Dr. Krumme and Dr. Bonanni), and the Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA (Dr. Patel and Dr. Golladay)
| | - Nirav K. Patel
- From the Department of Orthopaedic Surgery, University of Missouri–Kansas City, Kansas City, MO (Dr. Krumme and Dr. Bonanni), and the Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA (Dr. Patel and Dr. Golladay)
| | - Gregory J. Golladay
- From the Department of Orthopaedic Surgery, University of Missouri–Kansas City, Kansas City, MO (Dr. Krumme and Dr. Bonanni), and the Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA (Dr. Patel and Dr. Golladay)
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Thoen PS, Lygre SHL, Nordsletten L, Furnes O, Stigum H, Hallan G, Röhrl SM. Risk factors for revision surgery due to dislocation within 1 year after 111,711 primary total hip arthroplasties from 2005 to 2019: a study from the Norwegian Arthroplasty Register. Acta Orthop 2022; 93:593-601. [PMID: 35770369 PMCID: PMC9244827 DOI: 10.2340/17453674.2022.3474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 06/11/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Dislocation of a hip prosthesis is the 3rd most frequent cause (after loosening and infection) for hip revision in Norway. Recently there has been a shift in surgical practice including preferred head size, surgical approach, articulation, and fixation. We explored factors associated with the risk of revision due to dislocation within 1 year and analyzed the impact of changes in surgical practice. PATIENTS AND METHODS 111,711 cases of primary total hip arthroplasty (THA) from the Norwegian Arthroplasty Register were included (2005-2019) after primary THA with either 28 mm, 32 mm, or 36 mm femoral heads, or dualmobility articulations. A flexible parametric survival model was used to calculate hazard ratios for risk factors. Kaplan-Meier survival rates were calculated. RESULTS There was an increased risk of revision due to dislocation with 28 mm femoral heads (HR 2.6, 95% CI 2.0-3.3) compared with 32 mm heads. Furthermore, there was a reduced risk of cemented fixation (HR 0.6, CI 0.5-0.8) and reverse hybrid (HR 0.6, CI 0.5-0.8) compared with uncemented. Also, both anterolateral (HR 0.5, CI 0.4-0.7) and lateral (HR 0.6, CI 0.5-0.7) approaches were associated with a reduced risk compared with the posterior approach. The time-period 2010-2014 had the lowest risk of revision due to dislocation. The trend during the study period was towards using larger head sizes, a posterior approach, and uncemented fixation for primary THA. INTERPRETATION Patients with 28 mm head size, a posterior approach, or uncemented fixation had an increased risk of revision due to dislocation within 1 year after primary THA. The shift from lateral to posterior approach and more uncemented fixation was a plausible explanation for the increased risk of revision due to dislocation observed in the most recent time-period. The increased risk of revision due to dislocation was not fully compensated for by increasing femoral head size from 28 to 32 mm.
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Affiliation(s)
- Peder S Thoen
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Department of Surgery, Vestfold Hospital Trust, Tønsberg; Institute of Clinical Medicine, University of Oslo, Oslo.
| | - Stein Håkon Låstad Lygre
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen; Department of Occupational Medicine, Haukeland University Hospital, Bergen
| | - Lars Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo
| | - Ove Furnes
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen; Department of Clinical Medicine (K1), University of Bergen, Bergen
| | - Hein Stigum
- Department of Community Medicine and Global Health (Department of Health and Society), University of Oslo
| | - Geir Hallan
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen; Department of Clinical Medicine (K1), University of Bergen, Bergen; Department of Orthopaedic Surgery, Coastal Hospital at Hagevik, Norway
| | - Stephan M Röhrl
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo
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HERMANSEN LL, VIBERG B, OVERGAARD S. Patient-reported outcome after dislocation of primary total hip arthroplasties: a cross-sectional study derived from the Danish Hip Arthroplasty Register. Acta Orthop 2022; 93:29-36. [PMID: 34633915 PMCID: PMC8815764 DOI: 10.1080/17453674.2021.1983973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Knowledge regarding patient-reported outcomes (PROs) after dislocation and closed reduction is lacking. We report health- and hip-related quality of life (QoL) after dislocation, following primary total hip arthroplasty (THA). Patients and methods - We conducted a crosssectional study with patients registered in the Danish Hip Arthroplasty Register from 2010 to 2014. Dislocations were captured based on diagnosis/procedure codes and patient file reviews. Patients with dislocation were matched 1:2, according to age, sex, date, and hospital of primary surgery, to patients without dislocation. 2 PRO questionnaires were applied (EQ-5D, HOOS). Results - We identified 1,010 living patients with dislocation. Mean follow-up was 7.2 years from index surgery and 4.9 years (range 0.6-9.7) from the latest dislocation. Patients without dislocation reported a higher EQ VAS score of 76 (95% CI 75-77) compared with 68 (CI 66-70) for the dislocation group. The EQ-5D-5L mean index score was 0.89 (CI 0.88-0.90) for the control group, compared with 0.78 (CI 0.76-0.80) for the cases with dislocation without revision. Patients with dislocation reported a lower HOOSQoL domain score of 63 (CI 60-65), compared with 83 (CI 82-84) for the control group. Even 5 years after the latest dislocation, the HOOS-QoL score remained low, at 66 (CI 62-69). The other HOOS domains were consistently 8-10 points worse after dislocation. Interpretation - Both health- and hip-related QoL were markedly and persistently reduced among dislocation patients compared with those in controls, for several years. Therefore, the avoidance of the initial dislocation episode is important because the THA does not appear to achieve the full relieving potential.
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Affiliation(s)
- Lars L HERMANSEN
- Department of Orthopaedics, Hospital of South West Jutland, Esbjerg, Denmark,Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense/Department of Clinical Research, University of Southern Denmark, Denmark,OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Bjarke VIBERG
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark,Department of Regional Health Research, University of Southern Denmark
| | - Soeren OVERGAARD
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense/Department of Clinical Research, University of Southern Denmark, Denmark,The Danish Hip Arthroplasty Register
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