Functional Outcome following Revision Hip Arthroplasty with Complex Femoral Reconstruction. A self-reported outcome analysis
Keywords:
hip revision arthroplasty; extended trochanteric osteotomy; ETO; functional outcome; outcome analysisAbstract
urpose: There is not enough information in the literature regarding the functional outcome after major hip revision surgeries. Τhis study presents a self-reported outcome analysis of 37 patients following a complex hip revision arthroplasty performed with an extended trochanteric osteotomy (ETO).
Materials and Methods: Pre- and post-operative data were collected from an electronic database with a 2-year minimum follow-up. For this purpose, standardized questionnaires with emphasis on physical function, patient satisfaction and expectations, were used. Statistical analysis was performed to compare pre- and post-operative scores and to assess any relationship between score changes and certain factors.
Results: Self-reported outcome analysis revealed a significant improvement (p<0.001) in total Harris Hip Score (76.34 versus 48.03), and Western Ontario & McMaster Universities Osteoarthritis Index scores (pain: 2.27 versus 10.00, function: 15.58 versus 30.96, summary: 20.27 versus 44.58) post-operatively. Six out of eight subcategories of 36-Item Short-Form Health Survey demonstrated a significant upgrade postoperatively. Univariate analysis revealed that Charnley class B & C patients improved significantly less in five out of eight SF-36 items; whereas age, gender, BMI, number of previous revisions, degree of femoral bone loss and stem design had no influence on score improvement in any of the outcome measures (p>0.05). Satisfaction rate was high (92%).
Conclusions: Complex hip revisions provide good mid-term functional results and good satisfaction rates. However, patients should be advised not to have unrealistic expectations regarding their post-operative activity level. Further high-quality prospective studies are needed to establish the long-term functional outcome of hip revisions using ETO.
Downloads
References
2. Birrell F, Afzal C, Nahit E, Lunt M, Macfarlane GJ, Cooper C, et al. Predictors of hip joint replacement in new attenders in primary care with hip pain. Br J Gen Pract. 2003;53(486):26–30.
3. Felson D., & Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis & Rheumatism. 1998; 41(8), 1343-1355.
4. Dagenais S., Garbedian S. and Wai E. Systematic Review of the Prevalence of Radiographic Primary Hip Osteoarthritis. Clinical Orthopaedics and Related Research. 2008; 467(3), pp.623-637.
5. Krishnan E., Fries J. and Kwoh C.. Primary knee and hip arthroplasty among nonagenarians and centenarians in the United States. Arthritis & Rheumatism. 2007; 57(6), pp.1038-1042.
6. Jiang L., Rong J., Wang Y., Hu F., Bao C., Li X. and Zhao Y. The relationship between body mass index and hip osteoarthritis: A systematic review and meta-analysis. Joint Bone Spine. 2011; 78(2), pp.150-155.
7. King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013; 138:185–93
8. Reyes C., Leyland K., Pea G., Cooper C., Arden N. and Prieto-Alhambra D. Association Between Overweight and Obesity and Risk of Clinically Diagnosed Knee, Hip, and Hand Osteoarthritis: A Population-Based Cohort Study. Arthritis & Rheumatology. 2016; 68(8), pp.1869-1875.
9. Reginster J. The prevalence and burden of arthritis. Rheumatology. 2002; 41(90001), pp.3-6.
10. Quintana J., Arostegui I., Azkarate J., Goenaga I. and Lafuente I. Prevalence of Knee and Hip Osteoarthritis and the Appropriateness of Joint Replacement in an Older Population. Archives of Internal Medicine. 2008; 168(14), p.1576.
11. Pereira D., Peleteiro B., Araújo J., Branco J., Santos R. and Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis and Cartilage. 2011; 19(11), pp.1270-1285.
12. Nevitt M., Xu L., Zhang Y., Lui L., Yu W., Lane N., Qin M., Hochberg M., Cummings S. and Felson D. Very low prevalence of hip osteoarthritis among Chinese elderly in Beijing, China, compared with whites in the United States: The Beijing osteoarthritis study. Arthritis & Rheumatism. 2002; 46(7), pp.1773-1779.
13. Agabiti N., Picciotto S., Cesaroni G., Bisanti L., Forastiere F., Onorati R., Pacelli B., Pandolfi P., Russo A., Spadea T. and Perucci C. The influence of socioeconomic status on utilization and outcomes of elective total hip replacement: a multicity population-based longitudinal study. International Journal for Quality in Health Care. 2006; 19(1), pp.37-44.
14. Sturm R. The Effects of Obesity, Smoking, and Drinking on Medical Problems and Costs. Health Affairs. 2002; 21(2):245-253
15. Cooper C., Inskip H., Croft P., Campbell L., Smith G., Mclearn M., & Coggon D. Individual Risk factors for Hip Osteoarthritis: Obesity, Hip Injury and Physical Activity. American Journal Of Epidemiology. 1998; 147(6), 516-522.
16. Felson D., Anderson J., Naimark A., Hannan M., Kannel W., & Meenan R. Does smoking protect against osteoarthritis?. Arthritis & Rheumatism. 1989; 32(2), 166-172.
17. Dailiana Z., Papakostidou I., Varitimidis S., Liaropoulos L., Zintzaras E., & Karachalios T. et al.. Patient-reported quality of life after primary major joint arthroplasty: a prospective comparison of hip and knee arthroplasty. BMC Musculoskeletal Disorders. 2015; 16(1), 366.
18. Andrianakos A., Kontelis L.K., Karamitsos D.G., Aslanidis S.I., Georgountzos A.I., Kaziolas G.O. et al. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study. J Rheumatol. 2006; 33: 2507–2513
19. Ulucay C., Özler T., Guven M., Akman B., Kocadal A., & Altintas F. (2013). Etiology of coxarthrosis in patients with total hip replacement. Acta Orthopaedica Et Traumatologica Turcica. 2013; 47(5), 330-333.
20. Quintana J., Arostegui I., Escobar A., Azkarate J., Goenaga J. and Lafuente I. Prevalence of Knee and Hip Osteoarthritis and the Appropriateness of Joint Replacement in an Older Population. Archives of Internal Medicine. 2008; 168(14), pp.1576 - 84.
21. Goveia V., Mendoza I., Couto B., Ferreira J., Paiva E., Guimarães G. and Stoianoff, M. Profile of hip arthroplasty patients in a teaching hospital. Revista do Colégio Brasileiro de Cirurgiões. 2015; 42(2), pp.106-110.
22. Marks R. and Allegrante J. Body mass indices in patients with disabling hip osteoarthritis. Arthritis Research. 2002; 4(2), pp.112–116.
23. Franklin J., Ingvarsson T., Englund M. and Lohmander L. (2009). Sex differences in the association between body mass index and total hip or knee joint replacement resulting from osteoarthritis. Annals of the Rheumatic Diseases. 2009; 68(4), pp.536-540.
24. Turkiewicz A., Petersson I., Björk, J., Hawker G., Dahlberg L., Lohmander L. and Englund M. Current and future impact of osteoarthritis on health care: a population-based study with projections to year 2032. Osteoarthritis and Cartilage. 2014; 22(11), pp.1826-1832.
25. Hush J., Cameron K. and Mackey M. Patient Satisfaction With Musculoskeletal Physical Therapy Care: A Systematic Review. Physical Therapy. 2011; 91(1), pp.25-36.
26. Donabedian A. Evaluating the Quality of Medical Care. Milbank Quarterly. 2005; 83(4), pp.691-729.
