PMID- 37383868
OWN - NLM
STAT- MEDLINE
DCOM- 20230703
LR  - 20231116
IS  - 1555-1377 (Electronic)
IS  - 1541-5457 (Print)
IS  - 1541-5457 (Linking)
VI  - 43
IP  - 1
DP  - 2023
TI  - Outcomes Vary Significantly Using a Tiered Approach To Define Success After Total 
      Hip Arthroplasty.
PG  - 45-54
AB  - BACKGROUND: Clinical outcomes following primary total hip arthroplasty (THA) are 
      commonly assessed through patient-reported outcome measures (PROM). The purpose 
      of this study was to use progressively more stringent definitions of success to 
      evaluate clinical outcomes of primary THA at 1-year postoperatively and to 
      determine if demographic variables were associated with achievement of clinical 
      success. METHODS: The American Joint Replacement Registry (AJRR) was queried from 
      2012-2020 for primary THA. Patients that completed the following PROMs 
      preoperatively and 1-year postoperatively were included: Western Ontario and 
      McMaster Universities Arthritis Index (WOMAC), Hip Injury and Osteoarthritis 
      Outcome Score (HOOS) and HOOS for Joint Replacement (HOOS, JR). Mean PROM scores 
      were determined for each visit and between-visit changes were evaluated using 
      paired t-tests. Rates of achievement of minimal clinically important difference 
      (MCID) by distribution-based and anchor-based criteria, patient acceptable 
      symptom state (PASS), and substantial clinical benefit (SCB) were calculated. 
      Logistic regression was used to evaluate associations between demographic 
      variables and odds of success. RESULTS: 7,001 THAs were included. Mean 
      improvement in PROM scores were: HOOS, JR, 37; WOMAC-Pain, 39; WOMAC-Function, 41 
      (p<0.0001 for all). Rates of achievement of each metric were: distribution-based 
      MCID, 88-93%; anchor-based MCID, 68-90%; PASS, 47-84%; SCB, 68-84%. Age and sex 
      were the most influential demographic factors on achievement of clinical success. 
      CONCLUSION: There is significant variability in clinical outcomes at 1 year after 
      primary THA when using a tiered approach to define success from the patient's 
      perspective. Tiered approaches to interpretation of PROMs should be considered 
      for future research and clinical assessment. Level of Evidence: III.
CI  - Copyright (c) The Iowa Orthopaedic Journal 2023.
FAU - Carender, Christopher N
AU  - Carender CN
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa, USA.
FAU - Gulley, Morgan L
AU  - Gulley ML
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa, USA.
FAU - De, Ayushmita
AU  - De A
AD  - American Academy of Orthopedic Surgeons, Rosemont, Illinois, USA.
FAU - Bozic, Kevin J
AU  - Bozic KJ
AD  - Department of Surgery and Perioperative Care, University of Texas at Austin, 
      Austin, Texas, USA.
FAU - Callaghan, John J
AU  - Callaghan JJ
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa, USA.
FAU - Bedard, Nicholas A
AU  - Bedard NA
AD  - Department of Orthopedic Surgery, Division of Hip and Knee Reconstruction, Mayo 
      Clinic, Rochester, Minnesota, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Iowa Orthop J
JT  - The Iowa orthopaedic journal
JID - 8908272
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Hip
MH  - Lower Extremity
MH  - *Osteoarthritis, Hip/surgery
MH  - *Arthritis
MH  - Patient Reported Outcome Measures
PMC - PMC10296457
OTO - NOTNLM
OT  - MCID
OT  - PROM
OT  - minimally clinically important difference
OT  - patient-reported outcome measures
OT  - total hip arthroplasty
EDAT- 2023/06/29 13:42
MHDA- 2023/07/03 06:41
PMCR- 2023/01/01
CRDT- 2023/06/29 11:56
PHST- 2023/07/03 06:41 [medline]
PHST- 2023/06/29 13:42 [pubmed]
PHST- 2023/06/29 11:56 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
PST - ppublish
SO  - Iowa Orthop J. 2023;43(1):45-54.