A Comparison of Surgical Approaches for Primary Hip Arthroplasty: A Cohort Study of Patient Reported Outcome Measures (PROMs) and Early Revision Using Linked National Databases

Jameson, Simon; Mason, James; Baker, Paul; Gregg, P. J.; McMurtry, Ian; Deehan, David J.; Reed, Mike

doi:10.1016/j.arth.2013.11.027

Cited by 30 publications

(26 citation statements)

References 12 publications

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“…Thirdly, the existing PROMs have revealed an association between surgical factors, such as surgical approach, and outcome. 36,37 In addition, registry data have demonstrated low function after hip replacement to be a risk factor of subsequent revision. 38 However, considering the high volume of literature on PROMs in joint replacement from both registry and clinical studies, it is discouraging to realise how little is published on how PROMs are used in clinical practice to improve on results.…”

Section: Reimbursement On Resultsmentioning

confidence: 99%

“…It has been claimed that PROMs could help transform health care. 39 An impressive amount of research on the association between PROMs and factors such as patient demography, 7,33,40 comorbidities, 32,33,35,41 socioeconomic status 34 and surgical techniques [35][36][37] No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.…”

Section: Start the Transformationmentioning

confidence: 99%

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The use of patient-reported outcomes after routine arthroplasty

Rolfson

Malchau

2015

The Bone & Joint Journal

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Section: Reimbursement On Resultsmentioning

confidence: 99%

Section: Start the Transformationmentioning

confidence: 99%

The use of patient-reported outcomes after routine arthroplasty

Rolfson

Malchau

2015

The Bone & Joint Journal

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“…Recent studies of arthroplasty registries worldwide have revealed three international registries that collect patient-reported outcome measures (PROMs): the Swedish Total Hip Arthroplasty Register, the National Joint Registry for England, Wales and Northern Ireland, and the New Zealand Joint Registry 5,6 . The inclusion of PROMs has aided in the comparison of outcomes from different surgical approaches, the analysis of positive predictors of clinical outcome, and the study of comorbid conditions [7][8][9][10] .…”

Section: Principles Of Value-based Health Carementioning

confidence: 99%

Improving Value in Musculoskeletal Care Delivery

Wei

Hawker

Jevsevar

et al. 2015

The Journal of Bone and Joint Surgery-American Volume

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Improving value in musculoskeletal health care has emerged as an important objective in both the United States and Canada. In order to achieve this objective, providers need to have a clear definition of value and an infrastructure for measuring outcomes of interest to patients and costs over the episode of care. Although national patient registries have been established in the United States and Canada, they nevertheless lag behind other registries worldwide in terms of collecting patient-reported outcomes and capturing data from a wide cross-section of hospitals and physicians. With the help of professional medical societies and the creation of national initiatives, patient-reported outcomes data collection on a large scale may be possible, but many challenges remain regarding implementation. Alternatives to the fee-for-service payment model, including pay-for-reporting and pay-for-performance, may help incentivize physicians and health-care providers to obtain and improve on patient-reported outcomes data collection. Other payment reforms, such as bundled payments, have been piloted in certain regions, but their sustainability and long-term success are unclear at this time. Novel health-care delivery strategies aimed at improving quality, coordinating multispecialty care, and enhancing patient participation in shared decision-making have shown promise in improving patient-centered outcomes, but delivery models continue to vary greatly throughout the United States and Canada. The current status of musculoskeletal health-care delivery requires substantial change before the goal of improving patient outcomes and lowering health-care costs can be achieved.

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“…5 Each surgical approach has its theoretical benefits to the patient and surgeon, along with potential disadvantages and unique complications. The lateral approach has the advantage of good exposure of the acetabulum and femur, joint stability 6,7 through preservation of the posterior capsule, but suffers from gluteal dysfunction 8 and post-operative limp. 2 The posterior approach overcomes the disadvantages of the trans-gluteal lateral approach, 8 provides excellent exposure to the femur and acetabulum but suffers from a risk of instability through posterior capsulotomy and detachment of the short external rotators.…”

Section: Introductionmentioning

confidence: 99%

“…The lateral approach has the advantage of good exposure of the acetabulum and femur, joint stability 6,7 through preservation of the posterior capsule, but suffers from gluteal dysfunction 8 and post-operative limp. 2 The posterior approach overcomes the disadvantages of the trans-gluteal lateral approach, 8 provides excellent exposure to the femur and acetabulum but suffers from a risk of instability through posterior capsulotomy and detachment of the short external rotators. 6,7,9 The risk of instability has been partly mitigated through the advent of larger heads.…”

Section: Introductionmentioning

confidence: 99%

Early surgical complications of total hip arthroplasty related to surgical approach

Hoskins

Dowsey

Spelman

et al. 2020

ANZ Journal of Surgery

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Background: Total hip arthroplasty (THA) can be performed through a number of surgical approaches. The aim was to compare the incidence of early surgical complications in THA related to approach. Methods: A retrospective review of prospectively recorded data extracted from St. Vincent's Melbourne Arthroplasty Registry was performed between January 2006 and December 2016. Surgical approach was identified: lateral, posterior, anterior and superior. Primary outcome measure was return to theatre (RTT) for any cause within 1 year. Age, comorbidity, body mass index and femoral fixation were assessed for potential confounding. Secondary outcomes were RTT for revision procedure and for specific complications: intra or post-operative fracture, dislocation/instability, aseptic loosening and prosthetic joint injection (PJI). Variables were assessed for their association with outcome using unadjusted and adjusted quantile median regression for continuous outcomes and Cox proportional hazards regression for binary time-to-event outcomes. Results: There were a total of 2906 consecutive THA's recorded, 1413 lateral, 1188 posterior, 233 anterior and 72 superior. A total of 140 cases (4.5%) required RTT within 1 year. No approach was associated with RTT on unadjusted analyses or multivariate modelling. There was no association between approach and revision, PJI or periprosthetic fracture. The posterior approach was associated with 2.90 times the rate of dislocation relative to the lateral (P = 0.005). Conclusions: There was no difference in the RTT rate between surgical approaches for THA. There was no difference in revision rates, PJI or periprosthetic fracture. The posterior approach was associated with a higher rate of dislocation relative to the lateral, but not the anterior.

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A Comparison of Surgical Approaches for Primary Hip Arthroplasty: A Cohort Study of Patient Reported Outcome Measures (PROMs) and Early Revision Using Linked National Databases

Cited by 30 publications

References 12 publications

The use of patient-reported outcomes after routine arthroplasty

The use of patient-reported outcomes after routine arthroplasty

Improving Value in Musculoskeletal Care Delivery

Early surgical complications of total hip arthroplasty related to surgical approach

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