PMID- 34495897 OWN - NLM STAT- MEDLINE DCOM- 20220126 LR - 20230606 IS - 1535-1386 (Electronic) IS - 0021-9355 (Linking) VI - 103 IP - 24 DP - 2021 Dec 15 TI - Does Implant Selection Affect Patient-Reported Outcome Measures After Primary Total Hip Arthroplasty? PG - 2306-2317 LID - 10.2106/JBJS.20.01931 [doi] AB - BACKGROUND: Total hip arthroplasty (THA) is a reliable operation, but it is critical that orthopaedic surgeons characterize which surgical factors influence patient-reported outcomes. The purpose of this study was to determine whether implant selection at the time of THA affects the odds of having (1) inadequate improvement according to patient-reported pain, function, and activity; (2) failure to achieve a substantial clinical benefit (SCB) with respect to pain; or (3) failure to achieve a patient-acceptable symptomatic state (PASS) according to pain and function. METHODS: Prospective data were collected from 4,716 patients who underwent primary THA (from July 2015 to August 2018) in a single health-care system with standardized care pathways. Patients were categorized according to the type of femoral and acetabular components and bearing surface used. Outcomes included 1-year postoperative patient-reported outcome measures (PROMs) and improvement in the Hip disability and Osteoarthritis Outcome Score (HOOS) and the University of California at Los Angeles (UCLA) activity score. Inadequate improvement was defined as PROMs that changed by less than the minimal clinically important difference (MCID) for the HOOS pain and physical function short form (PS) and as failure to improve beyond a mostly homebound activity status for the UCLA activity score (a score of 0.05). Larger (36-mm) femoral heads demonstrated lower odds of inadequate improvement versus 28-mm femoral heads according to UCLA activity scores (odds ratio [OR]: 0.64; 95% confidence interval, 0.47 to 0.86; p = 0.003). Implant-related criteria were not significant drivers of attaining a PASS or achieving an SCB with respect to HOOS pain. CONCLUSIONS: For the most part, THA implant characteristics are not drivers of inadequate improvement with respect to pain and function. Surgeons should utilize implants with an acceptable track record that allow stable fixation and restoration of hip biomechanics. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. CI - Copyright (c) 2021 by The Journal of Bone and Joint Surgery, Incorporated. FAU - Campbell, Andrew AU - Campbell A AUID- ORCID: 0000-0002-9062-3572 AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Emara, Ahmed K AU - Emara AK AUID- ORCID: 0000-0002-8421-7340 FAU - Klika, Alison AU - Klika A AUID- ORCID: 0000-0003-2755-0742 FAU - Piuzzi, Nicolas S AU - Piuzzi NS AUID- ORCID: 0000-0003-3007-7538 CN - Cleveland Clinic OME Arthroplasty Group LA - eng PT - Journal Article PL - United States TA - J Bone Joint Surg Am JT - The Journal of bone and joint surgery. American volume JID - 0014030 SB - IM MH - Aged MH - Arthralgia/*diagnosis/etiology MH - Arthroplasty, Replacement, Hip/*instrumentation MH - Female MH - Follow-Up Studies MH - Hip Prosthesis/*adverse effects MH - Humans MH - Male MH - Middle Aged MH - Minimal Clinically Important Difference MH - Osteoarthritis, Hip/complications/surgery MH - Pain Measurement/statistics & numerical data MH - Pain, Postoperative/*diagnosis/etiology MH - *Patient Reported Outcome Measures MH - Prospective Studies MH - Treatment Outcome COIS- Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G699). EDAT- 2021/09/09 06:00 MHDA- 2022/01/27 06:00 CRDT- 2021/09/08 17:22 PHST- 2021/09/09 06:00 [pubmed] PHST- 2022/01/27 06:00 [medline] PHST- 2021/09/08 17:22 [entrez] AID - 00004623-202112150-00007 [pii] AID - 10.2106/JBJS.20.01931 [doi] PST - ppublish SO - J Bone Joint Surg Am. 2021 Dec 15;103(24):2306-2317. doi: 10.2106/JBJS.20.01931.