Influence of preoperative functional status on outcome after total hip arthroplasty

Röder, Christoph; Staub, Lukas P; Eggli, Stefan; Dietrich, Daniel; Busato, Andre; Müller, Urs (2007). Influence of preoperative functional status on outcome after total hip arthroplasty. Journal of bone and joint surgery - American volume, 89(1), pp. 11-7. Needham, Mass.: Journal of Bone & Joint Surgery Inc. 10.2106/JBJS.E.00012

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BACKGROUND: International registries with large, heterogeneous patient populations provide excellent research opportunities for studying factors that influence treatment outcomes after total hip arthroplasty. In the present study, we used a European multinational database to investigate whether there is an association between three functional variables (preoperative pain, mobility, and motion) and functional outcome. METHODS: We performed a retrospective cohort study on preoperative and follow-up clinical data that were prospectively entered into the International Documentation and Evaluation System European hip registry between 1967 and 2002. The inclusion criteria for this study were an age of more than twenty years, an underlying diagnosis of osteoarthritis, and a Charnley class-A functional designation at the time of surgery. A total of 12,925 patients (13,766 total hip arthroplasties) who met these criteria were entered into the analysis. Three functional variables (pain, mobility, and motion) that were assessed preoperatively were evaluated postoperatively at various follow-up examinations for a maximum of ten years. RESULTS: Six thousand four hundred and one patients could walk longer than ten minutes preoperatively; of these, 57.1% had a walking capacity of more than sixty minutes at the time of the most recent follow-up. In comparison, 6896 patients had a preoperative walking capacity of less than ten minutes and only 38.9% of these patients could walk more than sixty minutes at the time of the most recent follow-up. The difference was significant (p < 0.01). Similarly, 10,375 patients had a preoperative hip flexion range of >70 degrees ; of these, 74.7% had a flexion range of >90 degrees at the time of the most recent follow-up. In comparison, 2793 patients had a preoperative hip flexion range of <70 degrees and only 62.6% of these patients had a flexion range of >90 degrees at the time of the most recent follow-up. The difference was also significant (p < 0.01). Lasting, complete, or almost complete pain relief was achieved by >80% of the patients following total hip arthroplasty regardless of their preoperative categorization of pain. CONCLUSIONS: Patients with poor preoperative walking capacity and hip flexion are less likely to achieve an optimal outcome with regard to walking and motion. In contrast, there is no correlation between the preoperative pain level and pain alleviation, which is generally good and long-lasting after total hip arthroplasty.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Evaluative Research into Orthopaedic Surgery
UniBE Contributor:	Röder, Christoph, Eggli, Stefan, Müller, Urs (A)
ISSN:	0021-9355
ISBN:	17200304
Publisher:	Journal of Bone & Joint Surgery Inc.
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:57
Last Modified:	29 Mar 2023 23:33
Publisher DOI:	10.2106/JBJS.E.00012
PubMed ID:	17200304
Web of Science ID:	000243270500002
URI:	https://boris.unibe.ch/id/eprint/24462 (FactScience: 50768)