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The Influence of Radiological Severity and Symptom Duration of Osteoarthritis on Postoperative Outcome After Total Hip Arthroplasty: A Prospective Cohort Study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
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2018 (English)In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 33, no 2, p. 436-440Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to investigate the influence of preoperative radiological severity and symptom duration of hip osteoarthritis (OA) on the postoperative functional outcome, quality of life, as well as abductor muscle strength after total hip arthroplasty (THA). Methods: In this prospective cohort study, we studied 250 patients. Preoperatively, we evaluated the function with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life with euroqol-5D (EQ-5D). At 1 year after THA, the same scores and also hip abductor muscle strength were measured in 222 patients. We divided the cohort twice, first according to the radiological OA severity [Kellgren-Lawrence classification (KL)] and then according to the OA symptom duration. We investigated whether the preoperative KL class and symptom duration influenced the 1-year WOMAC (primary outcome measure) or EQ-5D and abductor muscle strength (secondary outcome measures). Results: The crude results showed that KL class and symptom duration had no influence (P = .90 and P = .20, respectively) on the 1-yearWOMAC. Younger age, male gender, and lower body mass index were associated with a better function. Regarding 1-year EQ-5D, the crude results showed that body mass index and KL class had no influence (P = .83 and P = .39, respectively). The adjusted results showed that only age and gender influenced the postoperative EQ-5D. No influence of the tested factors was found on the 1-year abductor muscle strength. Conclusion: Preoperative radiological OA severity and symptom duration had no influence on the outcome of THA and should probably not affect the decision about timing the operative intervention. 

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS , 2018. Vol. 33, no 2, p. 436-440
Keywords [en]
radiological severity, symptom duration, hip osteoarthritis, postoperative outcome, total hip throplasty
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:umu:diva-145155DOI: 10.1016/j.arth.2017.09.051ISI: 000424145000022PubMedID: 29066249OAI: oai:DiVA.org:umu-145155DiVA, id: diva2:1185910
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-11-08Bibliographically approved
In thesis
1. Radiological measurements in total hip arthroplasty
Open this publication in new window or tab >>Radiological measurements in total hip arthroplasty
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Every year, about 1 million patients worldwide and 20000 patients in Sweden undergo total hip arthroplasty (THA). This type of operation is considered a successful, safe and cost-effective procedure to regain mobility and restore hip joint function in patients suffering from severe hip joint disease or trauma. The main goals of the operation are to relief the pain, improve quality of life (QoL) and to restore the biomechanical forces around the hip with appropriate femoral offset (FO), leg length and proper component position and orientation. The radiographic preoperative planning and postoperative evaluation of these parameters require good validity, interobserver reliability and intraobserver reproducibility. Most patients are satisfied after THA, although this treatment still has its complications. About 10 % of THA patients report persistent pain and suboptimal functional outcome and QoL at long-term follow-up. The absolute number of dissatisfied patients is expected to rise given the increase in the annual number of THA performed. Therefore, every effort should be made to investigate factors that possibly influence THA outcome. The data available about the influence of preoperative radiological severity and symptom duration of OA on the outcome of THA are scarce and contradictory. Further studies even needed to evaluate the effect of obesity on post-operative THA radiological measurements

Abstract [sv]

Varje år opereras ungefär 1 miljon patienter runt om i världen och 20,000 patienter i Sverige med en total höftledsprotes (THA). Höftledsprotesoperation anses vara en av de mest framgångsrika, säkra och kostnadseffektiva kirurgiska åtgärderna med ett syfte att smärtlindra, återställa rörligheten och förbättra livskvaliteten. Höftleden drabbas av artros, åldersrelaterad sjukdom som orsakar destruktion av leden. Vid operation med THA är det viktigt att återställa de biomekaniska krafterna runt höftleden med en adekvat så kallad femoral offset (FO), avståndet mellan höftens rörelsecentrum och mitten av bäckenet, postoperativ benlängdsskillnad (BLS) och ett tillfredsställande komponentläge. Den preoperativa planeringen och den postoperativa röntgenbedömningen av dessa parametrar kräver god tillförlitlighet, det vill säga validitet och reproducerbarhet både mellan olika bedömare och vid upprepade mätningar av samma bedömare. Således är radiologiska mätningar före och efter THA oerhört viktiga för att få bästa resultat efter THA. Det finns inte tillräckligt med information i litteraturen om effekten av den preoperativa radiologiska artrosgraden och symptomduration av artrosen på utfallet av THA. Dessutom behövs ytterligare forskning för att studera effekten av obesitas på de radiologiska mätningarna efter THA.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 69
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1983
Keywords
Total hip arthroplasty, leg length discrepancy, femoral offset, WOMAC, quality of life, radiographicmeasurements, Kellgren-Lawrence, duration, acetabular cup, inclination, anteversion, BMI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-151862 (URN)978-91-7601-943-6 (ISBN)
Public defence
2018-10-12, Lionsalen, byggnad 7, målpunkt Y22, 2 tr, Umeå universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-09-21 Created: 2018-09-14 Last updated: 2018-11-08Bibliographically approved

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Al-Amiry, Bariq Sh.Kadum, Bakir K.Sayed-Noor, Arkan S.

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