Dataset Information

Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.

ABSTRACT:

Background

Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of life.

Questions/purposes

We sought to determine if any difference in quality of life measures could be detected in patients treated with total hip replacement implanted with cobalt-chrome (CoCr) versus ceramic femoral heads at 2-year follow-up.

Methods

We compared the hip disability and osteoarthritis outcome score (HOOS) and EuroQOL (EQ5D) scores of a matched set of patients that underwent primary total hip arthroplasty with highly cross-linked polyethylene (HXLPE) and a single implant system consisting of either a metal or a ceramic femoral head.

Results

Clinical outcomes and quality of life improved for both groups after hip replacement surgery. Patients with a ceramic head showed greater improvement than those with a metal head in HOOS pain and EQ5D VAS scores by a statistically significant margin (p?=?0.0417 and 0.019, respectively), but the differences between the HOOS and EQ5D VAS scores (3.4 and 0.04, respectively) do not demonstrate a clinically significant difference.

Conclusions

We found that the femoral head composition has no effect on clinical outcomes or patient quality of life at 2 years.

SUBMITTER: Ast MP

PROVIDER: S-EPMC4481248 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Publications

Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.

Ast Michael P MP Lyman Stephen S Gorab Alexandra H AH Parkes Natalie N Boles John J Lee Yuo-Yu YY Westrich Geoffrey H GH

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20150320 2

<h4>Background</h4>Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of ...[more]

PMID: 26140032

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Project description:OBJECTIVES:To determine if hospital arthroplasty volume affects patient outcomes after undergoing total hip arthroplasty (THA) for displaced femoral neck fractures. METHODS:The Statewide Planning and Research Cooperative System database from the New York State Department of Health was used to group hospitals into quartiles based on overall THA volume from 2000 to 2010. The database was then queried to identify all patients undergoing THA specifically for femoral neck fracture during this time period. The data were analyzed to investigate outcomes between the 4 volume quartiles in 30-day and 1-year mortality, 1-year revision rate, and 90-day complication rate (readmission for dislocation, deep vein thrombosis, pulmonary embolism, prosthetic joint infection, or other complications related to arthroplasty in the treatment of femoral neck fractures with THA). RESULTS:Patients undergoing THA for femoral neck fracture at hospitals in the top volume quartile had significantly lower 30-day (0.9%) and 1-year (7.51%) mortality than all other volume quartiles. There were no significant differences on pairwise comparisons between the second, third, and fourth quartiles with regard to postoperative mortality. There was no significant difference in revision arthroplasty at 1 year between any of the volume quartiles. On Cox regression analysis, THA for fracture at the lowest volume (fourth) quartile [hazard ratio (HR), 1.91; P = 0.016, 95% confidence interval (CI), (1.13-3.25)], second lowest volume (third) quartile (HR, 2.01; P = 0.013, 95% CI, 1.16-3.5) and third lowest volume (second) quartile (HR, 2.13; P = 0.005, 95% CI, 1.26-3.62) were associated with increased risk for a 1-year postoperative mortality event. Hospital volume quartile was also a significant risk factor for increased 90-day complication (pulmonary embolism/deep vein thrombosis, acute dislocation, prosthetic joint infection) following THA for femoral neck fracture. Having surgery in the fourth quartile (HR, 2.71; P < 0.001, 95% CI, 1.7-4.31), third quartile (HR, 2.61; P < 0.001, 95% CI, 1.61-4.23), and second quartile (HR, 2.41; P < 0.001, 95% CI, 1.51-3.84), all were significant risk factors for increased 90-day complication risk. CONCLUSIONS:The results of this population-based study indicate that THA for femoral neck fractures at high-volume arthroplasty centers is associated with lower mortality and 90-day complication rates but does not influence 1-year revision rate. THA for femoral neck fractures at top arthroplasty volume quartile hospitals are performed on healthier patients more quickly. Patient health is a critical factor that influences mortality outcomes following THA for femoral neck fractures. LEVEL OF EVIDENCE:Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Project description:BACKGROUND:The supercapsular percutaneously-assisted total hip arthroplasty (SuperPath) was proposed to be minimally invasive and tissue sparing with possible superior postoperative outcomes to traditional approaches of total hip arthroplasty (THA). Here, we compared the short-term outcomes of staged THA with the SuperPath or through posterolateral approach (PLA) for bilateral osteonecrosis of the femoral head (ONFH). METHODS:Patients with bilateral late-stage ONFH were prospectively recruited from our department from March 2017 to March 2018. Staged bilateral THAs with one side SuperPath and the other side PLA were performed consecutively in the same patients with right and left hips alternating within approaches. The average time interval between the staged THAs was 3?months. Perioperative status (operation time, incision length, intraoperative blood loss, soft tissue damage, and length of hospital stay) and postoperative function (range of motion, pain, and hip function) were recorded and compared between the SuperPath and PLA approaches within 12-month postoperatively. RESULTS:Four male patients (age, 51.00?±?4.54; BMI, 21.49?±?1.73) with bilateral alcohol-induced ONFH (Ficat III/IV) were followed up over 12?months postoperatively. Compared with the PLA, the SuperPath yielded shorter incision length (7.62 vs. 11.12?cm), longer operation time (103.25 vs. 66.50?min), more blood loss (1108.50 vs. 843.50?ml), deficient abduction angle of the acetabular cup (38.75° vs. 44.50°), and inferior early-term hip function (Harris hip score, 72.50 vs. 83.25) at 12-month postoperatively. Soft tissue damage, length of hospital stay, postoperative pain, postoperative range of motion, and 12-month patient satisfaction were comparable between both approaches. CONCLUSION:The SuperPath may be a minimally invasive technique but the present study shows less favorable short-term outcomes than PLA for total hip arthroplasty in osteonecrosis of the femoral head. More investigations are required to provide convincing favorable evidences of the SuperPath over other traditional THA approaches. TRIAL REGISTRATION INFORMATION:The trial was retrospectively registered in https://www.researchregistry.com (No. Researchregistry4993) on July 04, 2019. The first participant was enrolled on March 13, 2017.

Dataset Information

Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.

Background

Questions/purposes

Methods

Results

Conclusions

Publications

Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.

Similar Datasets

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