Tool Predicts Improved Function After Hip Arthroplasty

Preoperative characteristics and radiographic assessment predict functional improvement

TUESDAY, Jan. 17 (HealthDay News) -- Preoperative patient characteristics and radiographic assessment can be used to predict expected functional improvement for patients undergoing total hip arthroplasty (THA), according to a study published online Jan. 9 in Arthritis Care & Research.

Andy Judge, Ph.D., from Southampton General Hospital in the United Kingdom, and colleagues investigated predictors of functional improvement among 282 patients (aged ≥45 years) who underwent THA for primary osteoarthritis. Baseline data, including age, gender, comorbidity, body mass index (BMI), functional status (Short Form 36 [SF-36]), and preoperative radiographic severity, were collected by interview and examination. Patients were assessed approximately eight years after THA for clinically significant improvement, defined as a 30 point increase in SF-36 physical function.

The researchers found that improvement in physical functioning was more likely in those with worse radiographic grades (odds ratio [OR], 2.15); improvement was less likely in patients with better preoperative functioning (OR, 0.73), in older people (OR, 0.94), women (OR, 0.37), those with a previous hip injury (OR, 0.14), and in those with a greater number of painful joint sites (OR, 0.61). Predictors of good and bad outcomes were the same, acting in opposite directions. BMI and patient comorbidity did not impact functional outcome.

"Whilst we have shown that it is possible to construct a clinical tool from preoperative data to explain eight-year postoperative function, which has good internal discriminatory ability and good predictive characteristics, the clinical utility of such a proforma is an issue for further research," the authors write.

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