Patient-reported outcomes of femoral osteotomy and total hip arthroplasty for osteonecrosis of the femoral head: a prospective case series study.

Yusuke Kubo,Kazuyuki Karasuyama,Yukihide Iwamoto,Takuaki Yamamoto,Kazuhiko Sonoda,Goro Motomura

doi:10.1186/s40064-016-3576-4

Yusuke Kubo, Kazuyuki Karasuyama + Show 4 more

Open Access

https://doi.org/10.1186/s40064-016-3576-4

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Journal: SpringerPlus	Publication Date: Oct 26, 2016
Citations: 15	License type: CC BY 4.0

Affiliation: Kyushu University, Kyushu Rosai Hospital

Abstract

BackgroundPatient-reported scoring systems have recently been used after surgical procedures. The purpose of this prospective study was to evaluate the patient-reported outcomes of femoral osteotomy and total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH).MethodsForty-two symptomatic ONFH patients with asymptomatic contralateral hip underwent either transtrochanteric anterior rotational osteotomy (ARO) or THA as a primary operation. Of these, 20 patients whose contralateral hips remained asymptomatic at the final follow-up (more than 1 year postoperatively) were recruited to participate in this study. Nine patients were treated with ARO (ARO group) and 11 patients were treated with THA (THA group). Both the Oxford hip score (OHS) and the short form 36 (SF-36) were evaluated preoperatively and at the final follow-up.ResultsThe preoperative OHS was 29.1 ± 10.9 and 21.9 ± 9.6 points in the ARO and THA groups, which significantly improved to 38.4 ± 9.4 and 40.3 ± 5.1 points at the final follow-up, respectively. The preoperative physical component summary score was 30.8 ± 12.8 and 17.8 ± 14.5 points in the ARO group and THA groups, which significantly improved to 44.5 ± 10.6 and 43.3 ± 10.4 points at the final follow-up, respectively. The preoperative mental component summary score was 48.0 ± 8.5 and 48.6 ± 11.3 points in the ARO and THA groups, both of which remained unchanged at the final follow-up.ConclusionsThe short-term patient-reported outcomes of this study suggested that both ARO and THA for ONFH resulted in significantly improved postoperative hip joint function.

Highlights

Patient-reported scoring systems have recently been used after surgical procedures
Regarding the etiology of osteonecrosis of the femoral head (ONFH), corticosteroid use was associated with four hips in the anterior rotational osteotomy (ARO) group and six hips in the total hip arthroplasty (THA) group
The preoperative Japanese Orthopaedic Association (JOA) score was 58.1 ± 20.5 and 48.6 ± 16.7 points in the ARO and THA groups, which significantly improved to 81.9 ± 14.5 and 86.6 ± 10.6 points at the final follow-up, respectively (Fig. 3)

Summary

Introduction

Patient-reported scoring systems have recently been used after surgical procedures. The purpose of this prospective study was to evaluate the patient-reported outcomes of femoral osteotomy and total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH). Many studies have focused on ARO with the objective of improving the performance of surgery, which translates into an improvement of the joint preservation rate (Inao et al 1999; Mont et al 2006) In these studies, physician-reported scoring systems were commonly used as the surgical assessment. To the best of our knowledge, no previously published studies have prospectively examined the perioperative patient-reported outcomes of symptomatic ONFH in patients with an asymptomatic contralateral hip who underwent either ARO or THA as the primary operation. These evaluations are considered to be useful for patients at the early postcollapse stages, particular in the decision-making process of whether to preserve the joint or not. We prospectively evaluated the patient-reported outcomes of ARO and THA for ONFH

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