Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: 2014 Meeting of International Society of Arthroplasty Registers 9 articles

Articles

Are There Modifiable Risk Factors for Hospital Readmission After Total Hip Arthroplasty in a US Healthcare System?

Elizabeth W. Paxton MA, Maria C. S. Inacio PhD, Jasvinder A. Singh MD, MPH, Rebecca Love MPH, RN, Stefano A. Bini MD, Robert S. Namba MD

Although total hip arthroplasty (THA) is a successful procedure, 4% to 11% of patients who undergo THA are readmitted to the hospital. Prior studies have reported rates and risk factors of THA readmission but have been limited to single-center samples, administrative claims data, or Medicare patients. As a result, hospital readmission risk factors for a large proportion of patients undergoing THA are not fully understood.

Association of Bisphosphonate Use and Risk of Revision After THA: Outcomes From a US Total Joint Replacement Registry

Monti Khatod MD, Maria C. S. Inacio PhD, Richard M. Dell MD, Stefano A. Bini MD, Elizabeth W. Paxton MA, Robert S. Namba MD

Total hip arthroplasty (THA) is often performed in patients who are older and may take bisphosphonates to treat a variety of conditions, most commonly osteoporosis. However, the clinical effects of bisphosphonate use on patients who have undergone THA are not well described.

Do Rerevision Rates Differ After First-time Revision of Primary THA With a Cemented and Cementless Femoral Component?

Kirill Gromov MD, PhD, Alma B. Pedersen MD, PhD, Søren Overgaard MD, PhD, DMSc, Peter Gebuhr MD, Henrik Malchau MD, PhD, Anders Troelsen MD, PhD, DMSc

Worldwide use of cementless fixation for total hip arthroplasty (THA) is on the rise despite some evidence from the world’s registries suggesting inferior survivorship compared with cemented techniques. The patterns of bone loss associated with failed cementless and cemented THAs may prejudice the results of future revision procedures; however, this has not been documented.

Kaplan-Meier Survival Analysis Overestimates the Risk of Revision Arthroplasty: A Meta-analysis

Sarah Lacny MSc, Todd Wilson BSc, Fiona Clement PhD, Derek J. Roberts MD, Peter D. Faris PhD, William A. Ghali MD, MPH, Deborah A. Marshall PhD

Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown.

Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk

Dhiren Sheth MD, Guy Cafri PhD, Maria C. S. Inacio PhD, Elizabeth W. Paxton MA, Robert S. Namba MD

Lack of consensus continues regarding the benefit of anteriorly based surgical approaches for primary total hip arthroplasty (THA). The purpose of this study was to evaluate the risk of aseptic revision, septic revision, and dislocations for various approaches used in primary THAs from a community-based healthcare organization.

What Is the Rerevision Rate After Revising a Hip Resurfacing Arthroplasty? Analysis From the AOANJRR

James Min-Leong Wong MBBS, FRCS, Yen-Liang Liu M App Stats, Stephen Graves MBBS, Richard Steiger MBBS, FRACS, FA OrthoA

More than 15,000 primary hip resurfacing arthroplasties have been recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) with 884 primary procedures requiring revision for reasons other than infection, a cumulative percent revision rate at 12 years of 11%. However, few studies have reported the survivorship of these revision procedures.

Standard Comorbidity Measures Do Not Predict Patient-reported Outcomes 1 Year After Total Hip Arthroplasty

Meridith E. Greene BA, Ola Rolfson MD, PhD, Max Gordon MD, PhD, Göran Garellick MD, PhD, Szilard Nemes PhD

Comorbidities influence surgical outcomes and therefore need to be included in risk adjustment when predicting patient-reported outcomes. However, there is no consensus on how best to use the available data about comorbidities in registry-based predictive models.

The EQ-5D-5L Improves on the EQ-5D-3L for Health-related Quality-of-life Assessment in Patients Undergoing Total Hip Arthroplasty

Meridith E. Greene BA, Kevin A. Rader PhD, Göran Garellick MD, PhD, Henrik Malchau MD, PhD, Andrew A. Freiberg MD, Ola Rolfson MD, PhD

The EQ-5D is a generic health survey that can be used to compare improvement across different interventions, measure changes in health-related quality of life over time, or to explore cost-effectiveness among treatments, hospitals, or providers. The original EQ-5D survey has three response options for each of five health dimensions; however, with so few response options, ceiling and floor effects are problematic in some populations. A new version, called the EQ-5D-5L, was developed, which gives respondents five answer options (the “5L” refers to five response levels, which is in contrast to the original survey’s three levels). However, the validity of this version has not, to our knowledge, been evaluated in patients undergoing total hip arthroplasty (THA).