How long should patients be followed-up after total hip replacement? Current practice in the UK

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science

Background:

• Total hip replacement (THR) is a common procedure for managing hip osteoarthritis.
• Standardized follow-up protocols for THR patients are crucial for long-term outcomes.
• Current practices for monitoring primary THR patients vary significantly among orthopaedic surgeons.

Purpose of the Study:

• To investigate the current follow-up practices for primary total hip replacement (THR) patients among Fellows of the British Orthopaedic Association (BOA).
• To identify variations in follow-up duration and frequency based on prosthesis type (cemented, uncemented, hybrid).
• To explore factors influencing surgeons' ability to perform desired follow-up care.

Main Methods:

• A survey was conducted using postcard questionnaires distributed to approximately 1000 Fellows of the British Orthopaedic Association (BOA).
• The questionnaire aimed to establish current follow-up practices for primary total hip replacement (THR) patients.
• Data collected included follow-up duration and perceived barriers to providing adequate patient care.

Main Results:

• For cemented THRs, 50% of surgeons followed patients for under 1 year, and 78% for under 5 years; indefinite follow-up was provided by 14%.
• Uncemented and hybrid prostheses received significantly more follow-up (25%, 56%, and 30% respectively) compared to cemented types (chi-squared test, P < 0.0001).
• Over one-third of surgeons reported that clinic resource availability limited their ability to provide desired follow-up care.

Conclusions:

• There is considerable heterogeneity in total hip replacement follow-up practices among orthopaedic surgeons.
• Higher follow-up rates for uncemented components may indicate surgeon uncertainty regarding their long-term performance.
• Clinic resource limitations significantly impact the extent of patient follow-up provided by orthopaedic surgeons.