Zusammenfassung
Background: Total hip and knee replacements are frequently performed curative treatment options in end-stage arthritis. In this study, we analyzed clinical outcome, complications, and predictors of outcome in modern joint replacement. Methods: In a retrospective analysis of over 2000 primary total hip and knee replacements from our institutional joint registry, responder rates for positive ...
Zusammenfassung
Background: Total hip and knee replacements are frequently performed curative treatment options in end-stage arthritis. In this study, we analyzed clinical outcome, complications, and predictors of outcome in modern joint replacement. Methods: In a retrospective analysis of over 2000 primary total hip and knee replacements from our institutional joint registry, responder rates for positive outcome as defined by the OMERACT-OARSI criteria, postoperative complication rates, and patient-reported outcome measures (EQ-5D, WOMAC) within the first year were compared between hip and knee replacements. Furthermore, preoperative risk factors associated with nonresponder rate were evaluated. Results: Positive responder rate was higher for hip replacements with 92.8% (1145/1234) than for knee replacements with 86.1% (839/975, P < .001). Infection rates were lower (P = .04), whereas intraoperative fracture occurred more frequently (P = .001) in hip than in knee replacements. Patient-reported outcome measures 1 year after surgery were higher in hip than in knee replacements with EQ-5D (0.88 +/- 0.17 to 0.81 +/- 0.19, P < .001) and WOMAC (84.58 +/- 16.73 to 74.31 +/- 18.94, P < .001). Besides the type of joint replacement (hazard ratio [HR] 2.0, P < .001), high preoperative outcome measures (HR 7.4, P < .001) and male gender (HR 1.4, P = .05) were independent risk factors of nonresponders after joint replacement. Conclusion: Both total hip and knee replacements are safe procedures with low complication rates. Still, postoperative outcome is higher in hip than in knee arthroplasty. High preoperative clinical scores are a risk factor for poor clinical improvement following total joint replacement and can be used in counseling patients in the office. (C) 2017 Elsevier Inc. All rights reserved.
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