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Can patient-reported outcomes predict re-operations after total hip replacement?

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Patient-reported outcome measures (PROMs) one year after total hip replacement (THR) can predict re-operation risk. Worse PROMs, particularly pain and satisfaction, indicate a higher likelihood of needing further hip surgery.

Keywords:
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Area of Science:

  • Orthopedic surgery outcomes research
  • Patient-centered care evaluation
  • Health services research

Background:

  • Total hip replacement (THR) is a common procedure for osteoarthritis.
  • Monitoring patient outcomes post-THR is crucial for long-term success.
  • Identifying patients at risk for re-operation can improve resource allocation and patient management.

Purpose of the Study:

  • To determine if patient-reported outcome measures (PROMs) collected one year after total hip replacement (THR) can predict the risk of subsequent re-operation.
  • To evaluate the predictive power of various PROMs for re-operation following THR.

Main Methods:

  • Analysis of data from the Swedish Hip Arthroplasty Register, including 75,899 patients undergoing THR for osteoarthritis (2002-2014).
  • Utilized Kaplan-Meier survival analysis and Cox proportional hazards regression to assess the association between one-year PROMs and re-operation risk.
  • Concordance index (C) was used to evaluate the predictive accuracy of the models and individual PROMs.

Main Results:

  • The overall probability of not being re-operated at eight years post-THR was 95.5%.
  • Cox regression indicated that most PROMs, excluding EQ-VAS, were significantly associated with re-operation risk.
  • Patient satisfaction and pain levels, when assessed individually, demonstrated the highest predictive power (C=0.65) for re-operation.

Conclusions:

  • Poorer patient-reported outcomes one year after THR are associated with an increased risk of re-operation.
  • PROMs can serve as valuable tools for identifying patients at higher risk of requiring further hip surgery.
  • Early identification of at-risk patients allows for timely intervention and management of their issues.