Which factors are associated with a successful outcome following total hip arthroplasty in patients with early radiographic osteoarthritis?

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-03-11 DOI:10.1177/11207000241235892
Martin Sharrock, Tim N Board
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引用次数: 0

Abstract

Background: It is unclear which factors are associated with a successful total hip arthroplasty (THA) in patients with early radiographic osteoarthritis (OA).

Methods: 70 patients with early OA (Kellgren and Lawrence [KL] grades 0-2) who underwent THA were compared with 200 patients with advanced OA (KL grades 3-4). Outcomes were Oxford Hip Scores (OHS), EQ-5D and EQ-VAS scores; compared preoperatively with 1 year postoperatively. We investigated which clinical and radiographic (plain x-ray, CT, MRI) features predicted successful THA (postoperative OHS ⩾42).

Results: The early OA group were significantly younger (61 vs. 66 years; [p= 0.0035). There were no significant differences in BMI, ASA grade or gender. After adjusting for confounders, the advanced OA group had a significantly greater percentage of possible change (PoPC) in OHS (75.8% vs. 50.4%; p< 0.0001) and improvement in EQ-5D (0.151 vs. 0.002; p< 0.0001). There were no significant differences in complication, revision or readmission rates. In the early OA group, 16/70 (22.9%) patients had a 'successful' THA. Patients who had a 'successful' THA were significantly more likely to have subchondral cysts on CT/MRI (91.7% vs. 57.7%; p= 0.0362). The presence of cysts on CT/MRI was associated with a significantly greater PoPC in OHS (61.6% vs. 38.2%; p= 0.0353). The combination of cysts and joint space width <1 mm was associated with a PoPC of 68%.

Conclusions: THA in patients with early OA (KL grades 0-2) on plain radiographs should be indicated with caution. We advocate preoperative cross-sectional imaging in these patients. In the absence of cysts on CT/MRI, a THA seems unlikely to provide a satisfactory outcome.

哪些因素与早期放射性骨关节炎患者接受全髋关节置换术后的成功结果有关?
背景:方法:将 70 名接受全髋关节置换术的早期 OA(Kellgren 和 Lawrence [KL] 0-2 级)患者与 200 名晚期 OA(KL 3-4 级)患者进行比较。结果包括牛津髋关节评分(OHS)、EQ-5D 和 EQ-VAS 评分;术前与术后 1 年进行比较。我们研究了哪些临床和放射学(X光平片、CT、MRI)特征可预测THA的成功(术后OHS ⩾42):结果:早期 OA 组明显更年轻(61 岁对 66 岁;[p = 0.0035])。体重指数(BMI)、ASA 分级或性别无明显差异。在对混杂因素进行调整后,晚期 OA 组在 OHS(75.8% 对 50.4%;P 0.0001)和 EQ-5D 改善(0.151 对 0.002;P 0.0001)方面的可能变化百分比(PoPC)明显更高。在并发症、复发率或再入院率方面没有明显差异。在早期 OA 组中,16/70(22.9%)名患者的 THA 获得了 "成功"。成功 "THA的患者在CT/MRI上出现软骨下囊肿的几率明显更高(91.7% vs. 57.7%; p = 0.0362)。CT/MRI上出现囊肿与OHS的PoPC明显增加有关(61.6% vs. 38.2%; p = 0.0353)。结论:囊肿和关节间隙宽度的组合对早期 OA 患者的 THA 治疗具有重要意义:对于平片显示为早期 OA(KL 0-2 级)的患者,应慎用 THA。我们主张对这些患者进行术前横断面成像。如果 CT/MRI 检查未发现囊肿,THA 似乎不太可能带来令人满意的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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