Abstract
ObjectiveTo investigate differences in pre- and postoperative patient-relevant outcome between hybrid total hip replacement (THR) and cemented THR in patients with primary osteoarthritis (OA).Methods245 consecutive patients were included in the study. 68 of the patients (mean age 62) were operated on with hybrid THR and 177 (mean age 74) were operated on with cemented THR. All patients were investigated preoperatively and 0.5, 1 and 3.6 years postoperatively with two self-administered questionnaires, SF-36 and WOMAC (Western Ontario and MacMaster Universities Osteoarthritis Index, LK 3.0).ResultsPreoperatively, there was a difference in the SF-36 subscales RP (role physical) and GH (general health) where the patients with the hybrid THR attained better scores. At 3.6-years the patients with the hybrid THR reached better scores in all SF-36 subscales except BP (bodily pain) and GH. Further, they had better scores in WOMAC function. However, after adjusting for age, sex, follow-up time and baseline values there were no differences in outcome between the two different surgical techniques.ConclusionThis medium term (3–5 years), controlled, open cohort study, using patient-relevant outcome measures, did not reveal any differences between hybrid THR and cemented THR for OA at 3.6 years after surgery. Since the study had 75–94% power to detect the clinically significant score difference of 10 points, we suggest that any difference in outcome between these two methods is small and may require a large-scale, blinded, randomized trial to show.
Highlights
Since the development of total hip replacement (THR) there has been a wish to evaluate the results of the intervention
All patients were assigned for THR because of primary osteoarthritis (OA)
Major postoperative complications Two patients had been re-operated after the first follow-up year. Another three patients suffered from recurrent dislocations after the first follow-up year and one of those sustained an infection
Summary
Since the development of total hip replacement (THR) there has been a wish to evaluate the results of the intervention. 20 different hip scores have been introduced [1]. Inconsistent results have been found when comparing outcomes with scores which used descriptive terms such as excellent, good or failure, whereas there was better correlation between outcomes when using different numerical scores [1]. Callaghan et al [2] compared five different rating systems and found no uniformity in the results between ratings, nor any uniformity between the (page number not for citation purposes). A marked disparity has been shown between the patient's and the physician's scores after THR [3]. It is important and necessary to take into consideration the patient's point of view when evaluating health status and outcome after this intervention
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