Dataset Information

Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: introducing the Summary Notation for Arthroplasty Histories.

ABSTRACT:

Background and purpose

An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods.

Patients and methods

We obtained data from the Australian Orthopaedic Association National Joint Replacement Registry on patients (n = 84,759) who had undergone a total hip arthroplasty for osteoarthritis in the period 2002-2008. We set up a multi-state model where patients were followed from their first recorded arthroplasty to several possible states: revision of first arthroplasty, either a hip or knee as second arthroplasty, revision of the second arthroplasty, and death. The Summary Notation for Arthroplasty Histories (SNAH) was developed in order to help to manage and analyze this type of data.

Results

At the end of the study period, 12% of the 84,759 patients had received a second hip, 3 times as many as had received a knee. The estimated probabilities of having received a second arthroplasty decreased with age. Males had a lower transition rate for receiving a second arthroplasty, but a higher mortality rate.

Interpretation

Multi-state models in combination with SNAH codes are well suited to the management and analysis of arthroplasty registry data on patients who experience multiple joint procedures over time. We found differences in the progression of joint replacement procedures after the initial total hip arthroplasty regarding type of joint, age, and sex.

SUBMITTER: Gillam MH

PROVIDER: S-EPMC3369145 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Publications

Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: introducing the Summary Notation for Arthroplasty Histories.

Gillam Marianne H MH Ryan Philip P Salter Amy A Graves Stephen E SE

Acta orthopaedica 20120504 3

<h4>Background and purpose</h4>An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods.<h4>Patients and methods</h4>We obtained data from the Australian Orthopaedic Association National Joint Replacement Re ...[more]

PMID: 22553904

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Project description:BackgroundBecause people with total knee arthroplasty (TKA) have persistent functional limitations and disability, identifying modifiable risk factors for persistent disability is warranted. Before surgery, people have pervasive lower extremity muscle weakness. The fact that hip abductor muscle strength is often not targeted in postoperative rehabilitation may contribute to functional limitations.ObjectiveStudy objectives were: (1) to examine the reliability of handheld dynamometry (HHD) for measuring hip abductor strength and (2) to determine whether hip abductor strength contributes to physical function beyond the contribution of quadriceps muscle strength.DesignThis was a cross-sectional study.MethodsTwo-hundred ten participants underwent quadriceps and hip abductor muscle strength testing and measurement of physical function (performance-based and self-reported outcomes). Correlation and regression equations were built to determine the relationships of strength, pain, and functional ability. A subset of 16 participants underwent hip abductor strength testing at 2 sessions to determine the reliability of the measure.ResultsMeasuring hip abductor strength with HHD yielded excellent relative reliability, with an intraclass correlation coefficient (ICC [2,3]) of .95 and a 95% confidence interval of .86 to .98, but moderate absolute reliability, with a minimal detectable change (with 95% confidence) of 47.6 N and a 95% confidence interval of 35.5 to 76.5. Hip abductor strength made a significant additional contribution to performance-based measures of physical function after anthropometric covariates and quadriceps muscle strength were accounted for. Hip abductor strength did not show bivariate correlations with patient-reported measures of physical function and did not contribute to patient-reported physical function after covariates and quadriceps muscle strength were accounted for.LimitationsA cause-and-effect relationship between hip abductor strength and physical function could not be established.ConclusionsIn people with unilateral TKA, HHD testing of hip abductor strength is reliable. Hip abductor strength contributes to performance-based but not patient-reported measures of physical function in people with unilateral TKA.

Dataset Information

Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: introducing the Summary Notation for Arthroplasty Histories.

Background and purpose

Patients and methods

Results

Interpretation

Publications

Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: introducing the Summary Notation for Arthroplasty Histories.

Similar Datasets

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