Low Follow-Up Rates After a Total Hip Arthroplasty Prosthesis Recall
Leo H Cooper1, Stephen Wahl2, Jeffrey B Stambough1
1Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Background:
A modern hip arthroplasty liner was recalled for premature polyethylene wear with the potential for catastrophic osteolysis and failure. Physicians and hospitals are responsible for communicating recall information to patients. Our center instituted a protocol to reach patients who had recalled implants for follow-up. Our study looked at the effectiveness of this effort and risk factors for nonresponse.
Methods:
A retrospective study was performed to measure follow-up after total hip arthroplasty device recall. A standardized letter was used to reach out to all patients to notify them of the implant recall. Demographic information was collected, and an analysis was performed to determine risk factors for nonresponse.
Results:
Of the 763 patients, 58.8% (n = 449) followed up after recall letters were sent. There were significant differences in the follow-up rate found among the four surgeons who performed the total hip arthroplasties. Patient proximity to the performing institution (n = 264), performing surgeon, and adequate health literacy (n = 677) were significant predictors of follow-up (P < 0.05). Age, sex, body mass index, and race were not associated with follow-up.
Conclusion:
The overall rate of follow-up was less than 60% despite an organized process for contacting patients to return for evaluation after implant recall. Our findings raise concerns for the large number of patients who did not follow up with the potential catastrophic failure of their implants that could otherwise be avoided with early detection of implant malfunction. An improved system for contacting patients and ensuring appropriate follow-up with recalled devices is needed.
Level Of Evidence:
Retrospective cohort study, level IV.
