Pilot study: Is a long-term follow-up service beneficial for patients undergoing revision hip replacement surgery?

Total hip arthroplasty (THA) is highly successful but some patients will require later revision surgery. This pilot study evaluates the effects of long-term follow-up for patients undergoing revision hip replacement.

Consecutive patients undergoing aseptic revision of THA were recruited from a large orthopaedic unit to a single centre, observational study. Primary outcomes were changes in patient-reported scores from pre-revision to 12 months post-surgery. Secondary outcomes were costs during hospital stay up to 6 months post-revision. Participants were retrospectively allocated to two groups-those with regular orthopaedic review prior to revision (Planned revision) or those without (Unplanned revision).

52 patients were recruited, 7 were unrevised, one incomplete baseline questionnaires. There were 25 planned and 19 unplanned revisions with no significant differences between groups at baseline. At 12 months, 34 complete data sets were available for analysis, 17 in each group. Change scores were analysed with Mann-Whitney U test; none reached statistical significance. There was a significant difference for length of stay: Planned group 5 days (2-22), Unplanned 11 days (3-86) (Mann-Whitney U test, p = 0.023). No significant differences found for theatre time or component costs. Resource costs post-revision surgery are presented.

This pilot study indicates that some change in methods would be required for future work. The results show that there may be some financial benefit from providing long-term follow-up of THA but a larger study is needed to explore these findings and to discuss the impact on recommended guidelines.