The University of Southampton
University of Southampton Institutional Repository

The association of patient characteristics and surgical variables on symptoms of pain and function over 5 years following primary hip-replacement surgery: a prospective cohort study

The association of patient characteristics and surgical variables on symptoms of pain and function over 5 years following primary hip-replacement surgery: a prospective cohort study
The association of patient characteristics and surgical variables on symptoms of pain and function over 5 years following primary hip-replacement surgery: a prospective cohort study
OBJECTIVES: To identify patient characteristics and surgical factors associated with patient-reported outcomes over 5 years following primary total hip replacement (THR).

DESIGN: Prospective cohort study.

SETTING: Seven hospitals across England and Scotland.

PARTICIPANTS: 1431 primary hip replacements for osteoarthritis.

MAIN OUTCOME MEASURES: The Oxford Hip Score (OHS) was collected preoperatively and each year up to 5 years postoperatively. Repeated measures such as linear regression modelling are used to identify patient and surgical predictors of outcome and describe trends over time.

RESULTS: The majority of patients demonstrated substantial improvement in pain/function in the first year after surgery-between 1 and 5 years follow-up, there was neither further improvement nor decline. The strongest determinant of attained postoperative OHS was the preoperative OHS-those with worse preoperative pain/function had worse postoperative pain/function. Other predictors with small but significant effects included: femoral component offset-women with an offset of 44 or more had better outcomes; age-compared to those aged 50-60, younger (age <50) and older patients (age >60) had worse outcome, increasing body mass index (BMI), more coexisting diseases and worse Short Form 36 mental health (MH) was related to worse postoperative pain/function. Assessment of change in OHS between preoperative and postoperative assessments revealed that patients achieved substantial and clinically relevant symptomatic improvement (change), regardless of variation in these patient and surgical factors.

CONCLUSIONS: Patients received substantial benefit from surgery, regardless of their preoperative assessments and surgical characteristics (baseline pain/function, age, BMI, comorbidities, MH and femoral component offset). Further research is needed to identify other factors that can improve our ability to identify patients at risk of poor outcomes from THR surgery.
0959-8138
e002453
Judge, Andy
a7b98e8c-fd10-42be-a35a-ca6359038f95
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Batra, Rajbir N.
65f6f64d-d110-4691-9b11-6e36026541c9
Thomas, Geraint
d70eaeb1-d008-4d75-a518-75c3a14ea756
Beard, David
7bb0be51-1b39-4c53-b0c1-9d9e8c9df7e6
Javaid, M. Kassim
64155236-2ef0-4065-b684-cf723a888117
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Murray, David
3d2edcb9-2d12-4849-854a-937cd7938dc6
Judge, Andy
a7b98e8c-fd10-42be-a35a-ca6359038f95
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Batra, Rajbir N.
65f6f64d-d110-4691-9b11-6e36026541c9
Thomas, Geraint
d70eaeb1-d008-4d75-a518-75c3a14ea756
Beard, David
7bb0be51-1b39-4c53-b0c1-9d9e8c9df7e6
Javaid, M. Kassim
64155236-2ef0-4065-b684-cf723a888117
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Murray, David
3d2edcb9-2d12-4849-854a-937cd7938dc6

Judge, Andy, Arden, Nigel K., Batra, Rajbir N., Thomas, Geraint, Beard, David, Javaid, M. Kassim, Cooper, Cyrus and Murray, David (2013) The association of patient characteristics and surgical variables on symptoms of pain and function over 5 years following primary hip-replacement surgery: a prospective cohort study. British Medical Journal, 3 (3), e002453. (doi:10.1136/bmjopen-2012-002453). (PMID:23457332)

Record type: Article

Abstract

OBJECTIVES: To identify patient characteristics and surgical factors associated with patient-reported outcomes over 5 years following primary total hip replacement (THR).

DESIGN: Prospective cohort study.

SETTING: Seven hospitals across England and Scotland.

PARTICIPANTS: 1431 primary hip replacements for osteoarthritis.

MAIN OUTCOME MEASURES: The Oxford Hip Score (OHS) was collected preoperatively and each year up to 5 years postoperatively. Repeated measures such as linear regression modelling are used to identify patient and surgical predictors of outcome and describe trends over time.

RESULTS: The majority of patients demonstrated substantial improvement in pain/function in the first year after surgery-between 1 and 5 years follow-up, there was neither further improvement nor decline. The strongest determinant of attained postoperative OHS was the preoperative OHS-those with worse preoperative pain/function had worse postoperative pain/function. Other predictors with small but significant effects included: femoral component offset-women with an offset of 44 or more had better outcomes; age-compared to those aged 50-60, younger (age <50) and older patients (age >60) had worse outcome, increasing body mass index (BMI), more coexisting diseases and worse Short Form 36 mental health (MH) was related to worse postoperative pain/function. Assessment of change in OHS between preoperative and postoperative assessments revealed that patients achieved substantial and clinically relevant symptomatic improvement (change), regardless of variation in these patient and surgical factors.

CONCLUSIONS: Patients received substantial benefit from surgery, regardless of their preoperative assessments and surgical characteristics (baseline pain/function, age, BMI, comorbidities, MH and femoral component offset). Further research is needed to identify other factors that can improve our ability to identify patients at risk of poor outcomes from THR surgery.

Full text not available from this repository.

More information

Published date: 1 March 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 352680
URI: http://eprints.soton.ac.uk/id/eprint/352680
ISSN: 0959-8138
PURE UUID: ccc84f7e-f716-4269-b37f-f3b74d7e6755
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 16 May 2013 14:35
Last modified: 17 Dec 2019 01:56

Export record

Altmetrics

Contributors

Author: Andy Judge
Author: Nigel K. Arden
Author: Rajbir N. Batra
Author: Geraint Thomas
Author: David Beard
Author: M. Kassim Javaid
Author: Cyrus Cooper ORCID iD
Author: David Murray

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×