Weber, Markus and Craiovan, Benjamin and Woerner, Michael L. and Schwarz, Timo and Grifka, Joachim and Renkawitz, Tobias F. (2018) Predictors of Outcome After Primary Total Joint Replacement. JOURNAL OF ARTHROPLASTY, 33 (2). pp. 431-435. ISSN 0883-5403, 1532-8406
Full text not available from this repository.Abstract
Background: Total hip and knee replacements are frequently performed curative treatment options in end-stage arthritis. In this study, we analyzed clinical outcome, complications, and predictors of outcome in modern joint replacement. Methods: In a retrospective analysis of over 2000 primary total hip and knee replacements from our institutional joint registry, responder rates for positive outcome as defined by the OMERACT-OARSI criteria, postoperative complication rates, and patient-reported outcome measures (EQ-5D, WOMAC) within the first year were compared between hip and knee replacements. Furthermore, preoperative risk factors associated with nonresponder rate were evaluated. Results: Positive responder rate was higher for hip replacements with 92.8% (1145/1234) than for knee replacements with 86.1% (839/975, P < .001). Infection rates were lower (P = .04), whereas intraoperative fracture occurred more frequently (P = .001) in hip than in knee replacements. Patient-reported outcome measures 1 year after surgery were higher in hip than in knee replacements with EQ-5D (0.88 +/- 0.17 to 0.81 +/- 0.19, P < .001) and WOMAC (84.58 +/- 16.73 to 74.31 +/- 18.94, P < .001). Besides the type of joint replacement (hazard ratio [HR] 2.0, P < .001), high preoperative outcome measures (HR 7.4, P < .001) and male gender (HR 1.4, P = .05) were independent risk factors of nonresponders after joint replacement. Conclusion: Both total hip and knee replacements are safe procedures with low complication rates. Still, postoperative outcome is higher in hip than in knee arthroplasty. High preoperative clinical scores are a risk factor for poor clinical improvement following total joint replacement and can be used in counseling patients in the office. (C) 2017 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL KNEE ARTHROPLASTY; TOTAL HIP-REPLACEMENT; QUALITY-OF-LIFE; HIGH-FLEXION; OSTEOARTHRITIS; SURGERY; WOMAC; RESPONSIVENESS; COMPLICATIONS; COSTS; total joint replacement; outcome; complications; responder; prediction |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 19 Mar 2020 09:03 |
| Last Modified: | 19 Mar 2020 09:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15133 |
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