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Patient Reported Outcomes After Conversion vs. Primary Total Hip Arthroplasty: A Propensity Matched Analysis
Jason S Lipof1, Brittany E Haws1, David A Quinzi1
1Department of Orthopaedics, Rochester, University of Rochester Medical Center, Rochester, New York, USA.
The Iowa Orthopaedic Journal
|January 5, 2023
Summary
Conversion total hip arthroplasty (cTHA) offers comparable outcomes to primary total hip arthroplasty (pTHA) despite longer hospital stays and increased use of revision implants. This salvage procedure shows similar complication and reoperation rates, demonstrating equivalent patient-reported functional improvements.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Hip Reconstruction
Background:
- Conversion total hip arthroplasty (cTHA) is an emerging salvage procedure for hip and acetabular complications.
- Outcomes of cTHA compared to primary total hip arthroplasty (pTHA) are not well-established.
- This study compares patient-reported outcomes and complication rates between cTHA and pTHA.
Purpose of the Study:
- To evaluate and compare patient-reported outcomes (PROs) following conversion total hip arthroplasty (cTHA) versus primary total hip arthroplasty (pTHA).
- To assess and compare complication and reoperation rates between cTHA and pTHA cohorts.
Main Methods:
- Retrospective analysis of 118 patients (59 cTHA, 59 pTHA) from 2015-2020.
- Propensity matching based on age, BMI, and sex.
- Comparison of preoperative and postoperative PROMIS scores and complication rates using t-tests and chi-square analysis.
Main Results:
- Conversion THA (cTHA) patients had longer hospital stays (3.6 vs 1.9 days) and higher revision implant use (39% vs 0%).
- No significant differences were found in complication rates (15.3% vs 8.5%) or reoperation rates (5.1% vs 6.8%) between cTHA and pTHA.
- Both groups showed similar improvements in PROMIS scores at final follow-up.
Conclusions:
- Conversion total hip arthroplasty (cTHA) requires more revision implants and longer hospital stays than primary total hip arthroplasty (pTHA).
- Despite these differences, cTHA demonstrates comparable complication rates, reoperation rates, and patient-reported functional outcomes to pTHA.
- cTHA is a viable option for salvage procedures with similar functional recovery to primary procedures.
