Patient-reported outcome after primary and aseptic revision hip arthroplasty: 1-year follow-up of 3,559 primary and 406 revision THAs in an institutional registry

Abstract

Background and purpose — Patient-reported outcomes (PROMs) after primary total hip arthroplasty (THA) and revision THA are important information in the preoperative shared decision-making process. We present 1-year results on pain, function, and quality of life following primary and revision THA. Patients and methods — From 2010 to 2018, 3,559 primary THA and 406 revision THAs were included in our institutional quality registry. PROMs were registered preoperatively, 3 months, and 1 year after surgery, numeric rating scale (0–10) for pain during mobilization and at rest, healthrelated quality of life (EQ-5D), and a hip-specific physical function score (HOOS-PS). 2 anchor questions were asked 1 year after surgery concerning joint function and willingness to go through surgery again. Results — There were statistically significant improvements in all PROMs at the 3-month follow-up in both groups. All PROMs improved more in the primary group relative to the revision group. 1 year after surgery, pain during mobilization was reduced with a mean change of 5.1 (SD 2.6) for primary THA and 2.9 (SD 3.0) for revision THA. 93% of primary THA patients reported both better function 1 year after surgery and that they would have gone through surgery again, compared with 78% and 79% in the revision THA group. Interpretation — Primary THA patients reported better function and more pain relief than the revision THA group 1 year after surgery. Pain during mobilization shows the most marked improvement in both groups, which is important preoperative information for patients.

The extent of first-time THA revision is not associated with patient-reported outcomes at 1-year follow-up: a study of 426 aseptic revisions

“…The fast-track patient course has conventionally been applied to primary arthroplasties but has recently been demonstrated to also yield good results in rTHA [ 7 ]. In addition to meting preoperative expectations and providing the patient with a satisfactory hospital experience, pain relief is the most important outcome for the patient [ 8 , 9 ]. It has previously been found that patients undergoing aseptic rTHA improve pain and PROMs at 1-year follow-up [ 4 , 9 ], and it has recently been demonstrated that 2-year postoperative PROMs are not associated with the indication for rTHA [ 10 ].…”

“…In addition to meting preoperative expectations and providing the patient with a satisfactory hospital experience, pain relief is the most important outcome for the patient [ 8 , 9 ]. It has previously been found that patients undergoing aseptic rTHA improve pain and PROMs at 1-year follow-up [ 4 , 9 ], and it has recently been demonstrated that 2-year postoperative PROMs are not associated with the indication for rTHA [ 10 ]. However, to what extent the type of rTHA influences PROMs has not been studied and needs further investigation.…”