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Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)

BACKGROUND: Little is known about the impact of the reason for revision total hip arthroplasty (THA) on the outcomes following revision THA. In this study, our objective was to assess the association of operative diagnosis with patient-reported outcomes (PROs) after revision THA. METHODS: We used pr...

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Autores principales: Singh, Jasvinder A, Lewallen, David G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722075/
https://www.ncbi.nlm.nih.gov/pubmed/23866848
http://dx.doi.org/10.1186/1471-2474-14-210
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author Singh, Jasvinder A
Lewallen, David G
author_facet Singh, Jasvinder A
Lewallen, David G
author_sort Singh, Jasvinder A
collection PubMed
description BACKGROUND: Little is known about the impact of the reason for revision total hip arthroplasty (THA) on the outcomes following revision THA. In this study, our objective was to assess the association of operative diagnosis with patient-reported outcomes (PROs) after revision THA. METHODS: We used prospectively collected data from the Mayo Clinic Total Joint Registry that collects pre- and post-operative pain and function outcomes using a validated Hip questionnaire, on all revision THAs from 1993–2005. We used logistic regression to assess the odds of moderate-severe index hip pain and moderate-severe limitation in activities of daily living (ADLs) 2- and 5-years after revision THA. We calculated odds ratios (OR) and 95% confidence intervals (CIs). RESULTS: For the 2- and 5-year cohorts, the operative diagnosis was loosening/wear/osteolysis in 73% and 75%; dislocation/bone or prosthesis fracture/instability or non-union in 17% and 15%; and failed prior arthroplasty with components removed/infection in 11% and 11%, respectively. In multivariable-adjusted analyses that included preoperative ADL limitations, compared to patients with loosening/wear/osteolysis, patients with dislocation/fracture/instability/non-union had OR of 2.2 (95% CI, 1.3-3.5; p = 0.002) for overall moderate-severe ADL limitation and those with failed prior arthroplasty/infection had OR of 1.6 (95% CI, 1.0-2.8; p = 0.06). At 5-years, ORs were lower and differences were no longer significant. Moderate-severe pain did not differ significantly by diagnosis, at 2- or 5-years in multivariable adjusted analyses, with one exception, i.e. failed prior arthroplasty/infection had a trend towards significance with odds ratio of 1.9 (95% CI, 0.9-3.8; p = 0.07). CONCLUSIONS: Operative diagnosis is independently associated with ADL limitations, but not pain, at 2-years after revision THA. Patients should be informed of the risk of poorer short-term outcomes based on their diagnosis.
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spelling pubmed-37220752013-07-25 Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs) Singh, Jasvinder A Lewallen, David G BMC Musculoskelet Disord Research Article BACKGROUND: Little is known about the impact of the reason for revision total hip arthroplasty (THA) on the outcomes following revision THA. In this study, our objective was to assess the association of operative diagnosis with patient-reported outcomes (PROs) after revision THA. METHODS: We used prospectively collected data from the Mayo Clinic Total Joint Registry that collects pre- and post-operative pain and function outcomes using a validated Hip questionnaire, on all revision THAs from 1993–2005. We used logistic regression to assess the odds of moderate-severe index hip pain and moderate-severe limitation in activities of daily living (ADLs) 2- and 5-years after revision THA. We calculated odds ratios (OR) and 95% confidence intervals (CIs). RESULTS: For the 2- and 5-year cohorts, the operative diagnosis was loosening/wear/osteolysis in 73% and 75%; dislocation/bone or prosthesis fracture/instability or non-union in 17% and 15%; and failed prior arthroplasty with components removed/infection in 11% and 11%, respectively. In multivariable-adjusted analyses that included preoperative ADL limitations, compared to patients with loosening/wear/osteolysis, patients with dislocation/fracture/instability/non-union had OR of 2.2 (95% CI, 1.3-3.5; p = 0.002) for overall moderate-severe ADL limitation and those with failed prior arthroplasty/infection had OR of 1.6 (95% CI, 1.0-2.8; p = 0.06). At 5-years, ORs were lower and differences were no longer significant. Moderate-severe pain did not differ significantly by diagnosis, at 2- or 5-years in multivariable adjusted analyses, with one exception, i.e. failed prior arthroplasty/infection had a trend towards significance with odds ratio of 1.9 (95% CI, 0.9-3.8; p = 0.07). CONCLUSIONS: Operative diagnosis is independently associated with ADL limitations, but not pain, at 2-years after revision THA. Patients should be informed of the risk of poorer short-term outcomes based on their diagnosis. BioMed Central 2013-07-17 /pmc/articles/PMC3722075/ /pubmed/23866848 http://dx.doi.org/10.1186/1471-2474-14-210 Text en Copyright © 2013 Singh and Lewallen; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Singh, Jasvinder A
Lewallen, David G
Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title_full Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title_fullStr Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title_full_unstemmed Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title_short Operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (PROs)
title_sort operative diagnosis for revision total hip arthroplasty is associated with patient-reported outcomes (pros)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722075/
https://www.ncbi.nlm.nih.gov/pubmed/23866848
http://dx.doi.org/10.1186/1471-2474-14-210
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