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Predictors of Outcome After Primary Total Joint Replacement
Markus Weber1, Benjamin Craiovan1, Michael L Woerner1
1Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany.
The Journal of Arthroplasty
|October 3, 2017
Summary
Total hip replacements show higher success rates and better patient outcomes than knee replacements. High preoperative scores predict poorer results, aiding in patient counseling for joint replacement surgery.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Patient Outcomes
Background:
- Total hip and knee replacements are common treatments for end-stage arthritis.
- This study evaluates clinical outcomes, complications, and outcome predictors in modern joint replacement procedures.
Purpose of the Study:
- To compare clinical outcomes, complication rates, and patient-reported measures between hip and knee replacements.
- To identify preoperative risk factors associated with nonresponse to joint replacement surgery.
Main Methods:
- Retrospective analysis of over 2000 primary total hip and knee replacements.
- Comparison of responder rates (OMERACT-OARSI criteria), complication rates, and patient-reported outcomes (EQ-5D, WOMAC) within one year.
- Evaluation of preoperative risk factors for nonresponse.
Main Results:
- Hip replacements had a higher positive responder rate (92.8%) than knee replacements (86.1%).
- Lower infection rates but more intraoperative fractures were observed in hip replacements.
- Patient-reported outcomes (EQ-5D, WOMAC) were significantly better after hip replacement one year post-surgery.
- Independent risk factors for nonresponse included the type of joint replacement, high preoperative scores, and male gender.
Conclusions:
- Total hip and knee replacements are safe procedures with low complication rates.
- Postoperative outcomes are generally better following total hip arthroplasty compared to total knee arthroplasty.
- High preoperative clinical scores are identified as a risk factor for suboptimal improvement, useful for patient counseling.
