scholarly journals 1263 Does Multimorbidity Influence the Likelihood of Receiving A Total Hip Replacement for Osteoarthritis?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Ferguson ◽  
D Prieto-Alhambra ◽  
G Peat ◽  
K Jordan ◽  
J Valderas ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Frailty Index ◽  
Hip Osteoarthritis ◽  
Healthcare Management ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Total Hip ◽  
Kaplan Meier ◽  
The Uk

Abstract Introduction Limited data are available on the influence of multimorbidity on the outcomes of total hip replacement for patients with hip osteoarthritis. Thus, patients with multimorbidity and their clinicians across the UK are making decisions on whether or not to proceed with total hip replacement without clear information available on the potential risks and benefits. It is not known how such patients are currently managed. The aim of this study was to investigate the influence of multimorbidity on the likelihood of receiving total hip replacement in patients with hip osteoarthritis in the UK. Method A cohort study was performed, with cohort comprised of all patients over 65 years with a diagnosis of hip osteoarthritis recorded in Clinical Practice Research Datalink. Severity of multimorbidity burden was measured using four different scores (Charlson Comorbidity Index, Electronic Frailty Index, count of drugs prescribed, count of primary care interactions). The outcome was total hip replacement, evaluated using Kaplan-Meier survival and competing-risk analyses. Results 28,025 patients were included. 10,948 patients underwent total hip replacement. Increased multimorbidity burden was associated with decreased likelihood of undergoing surgery, irrespective of the method of scoring multimorbidity. Electronic Frailty Index had the largest difference between categories. Adjusted hazard ratio (‘severe multimorbidity versus ‘fit’) was 0.34 (95% CI 0.22, 0.51). Conclusions Patients with hip osteoarthritis and concurrent multimorbidity were up to two thirds less likely to undergo total hip replacement. Whether this difference in healthcare management is appropriate depends on to what extent multimorbidity influences the outcomes of total hip replacement.

scholarly journals 1279 Does Multimorbidity Influence the Outcomes of Total Hip Replacement for Osteoarthritis?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Ferguson ◽  
D Prieto-Alhambra ◽  
G Peat ◽  
K Jordan ◽  
J Valderas ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Frailty Index ◽  
Hip Osteoarthritis ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Total Hip ◽  
Functional Benefit ◽  
Increased Risk ◽  
The Uk

Abstract Introduction Limited data are available on the influence of multimorbidity on the outcomes of total hip replacement for patients with hip osteoarthritis, including the rate of complications and degree of functional benefit. The aim of this study was to investigate the influence of multimorbidity on the outcomes of total hip replacement in the UK. Method A cohort study was performed, with cohort comprised of all patients over 65 years with a diagnosis of hip osteoarthritis recorded in Clinical Practice Research Datalink and receipt of primary total hip replacement recorded in Hospital Episode Statistics Admitted Patient Care. Severity of multimorbidity burden was measured using four different scores (Charlson Comorbidity Index, Electronic Frailty Index, count of drugs prescribed, count of primary care interactions). The outcomes were (i) the risks of total hip replacement, assessed by serious post-operative complications within 90 days (analysed with logistic regression), and (ii) the benefits of surgery, assessed by post-operative Oxford Hip Score (OHS) and EQ-5D quality of life score (analysed with linear regression). Results 6,682 patients were included. The rate of complications was 3.2%. Patients with severe multimorbidity burden were at 1.5 to 2.5 times increased risk of complications than patients without multimorbidity. There was no clinically meaningful difference in the benefits of surgery between patients with and without multimorbidity, irrespective of the method of scoring multimorbidity. Conclusions Even for patients with severe multimorbidity burden, the potential benefits of total hip replacement for osteoarthritis remain substantial, while the increase in risk is relatively small.

scholarly journals Development and validation of prediction models to estimate risk of primary total hip and knee replacements using data from the UK: two prospective open cohorts using the UK Clinical Practice Research Datalink

2018 ◽  
Vol 78 (1) ◽  
pp. 91-99 ◽  
Author(s):  
Dahai Yu ◽  
Kelvin P Jordan ◽  
Kym I E Snell ◽  
Richard D Riley ◽  
John Bedson ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Prediction Models ◽  
Cox Proportional Hazards ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Total Hip ◽  
Risk Of Death ◽  
Geographical Regions ◽  
The Uk

ObjectivesThe ability to efficiently and accurately predict future risk of primary total hip and knee replacement (THR/TKR) in earlier stages of osteoarthritis (OA) has potentially important applications. We aimed to develop and validate two models to estimate an individual’s risk of primary THR and TKR in patients newly presenting to primary care.MethodsWe identified two cohorts of patients aged ≥40 years newly consulting hip pain/OA and knee pain/OA in the Clinical Practice Research Datalink. Candidate predictors were identified by systematic review, novel hypothesis-free ‘Record-Wide Association Study’ with replication, and panel consensus. Cox proportional hazards models accounting for competing risk of death were applied to derive risk algorithms for THR and TKR. Internal–external cross-validation (IECV) was then applied over geographical regions to validate two models.Results45 predictors for THR and 53 for TKR were identified, reviewed and selected by the panel. 301 052 and 416 030 patients newly consulting between 1992 and 2015 were identified in the hip and knee cohorts, respectively (median follow-up 6 years). The resultant model C-statistics is 0.73 (0.72, 0.73) and 0.79 (0.78, 0.79) for THR (with 20 predictors) and TKR model (with 24 predictors), respectively. The IECV C-statistics ranged between 0.70–0.74 (THR model) and 0.76–0.82 (TKR model); the IECV calibration slope ranged between 0.93–1.07 (THR model) and 0.92–1.12 (TKR model).ConclusionsTwo prediction models with good discrimination and calibration that estimate individuals’ risk of THR and TKR have been developed and validated in large-scale, nationally representative data, and are readily automated in electronic patient records.

scholarly journals Validation of hip osteoarthritis diagnosis recording in the UK Clinical Practice Research Datalink

2018 ◽  
Vol 28 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Rory J. Ferguson ◽  
Daniel Prieto‐Alhambra ◽  
Christine Walker ◽  
Dahai Yu ◽  
Jose M. Valderas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Hip Osteoarthritis ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
The Uk

scholarly journals Total Hip Replacement: Results of a Postal Survey of Current Practice on the Cement Fixation of the Acetabular Cup in the UK

2004 ◽  
Vol 14 (3) ◽  
pp. 155-162
Author(s):  
R. Mootanah ◽  
P. Ingle ◽  
K. Cheah ◽  
J. K. Dowell ◽  
J. C. Shelton
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Current Practice ◽  
Postal Survey ◽  
Acetabular Cup ◽  
Total Hip ◽  
The Uk

scholarly journals A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement

2016 ◽  
Vol 22 ◽  
pp. 2635-2642 ◽  
Author(s):  
Marek Łyp ◽  
Ryszard Kaczor ◽  
Anna Cabak ◽  
Piotr Tederko ◽  
Ewa Włostowska ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Rehabilitation Program ◽  
Total Hip ◽  
Before And After

scholarly journals What does standard rehabilitation practice after total hip replacement in the UK entail? results of a mixed methods study

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Tosan Okoro ◽  
Ashok Ramavath ◽  
Jan Howarth ◽  
Jane Jenkinson ◽  
Peter Maddison ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Mixed Methods Study ◽  
Total Hip ◽  
The Uk

scholarly journals Joint preservation surgery: a priority to be thought of in selective hip osteoarthritis

2020 ◽  
Vol 6 (2) ◽  
pp. 404
Author(s):  
Subramaian Kanthalu Narayanan ◽  
Rajesh Sellappan
Keyword(s):  
Total Hip Replacement ◽  
Femoroacetabular Impingement ◽  
Hip Replacement ◽  
Severe Pain ◽  
Hip Osteoarthritis ◽  
Total Hip ◽  
Joint Preservation ◽  
Arthroscopic Excision ◽  
Oxford Hip Score ◽  
Acetabular Rim

<p class="abstract">Femoroacetabular impingement (FAI) is one of the causes of hip arthritis. If FAI diagnosed earlier and treated properly, arthritis of hip and eventual total hip replacement (THR) can be potentially avoided. We report 48 yr male who presented with left hip severe pain, limp, restricted movements and unable do daily day activities. He is diagnosed to have pincer type of lesion in the acetabular rim and we did arthroscopic excision of the protruding fragment. The patient now has a pain free joint and able to squat and sit cross leg. His pre-operative oxford hip score was 30 which improved to 54. </p>

Outcomes of Total Hip Replacement in Limbs Affected by Poliomyelitis

2016 ◽  
Vol 27 (2) ◽  
pp. 198-204
Author(s):  
Cesare Faldini ◽  
Marcello De Fine ◽  
Alberto Di Martino ◽  
Daniele Fabbri ◽  
Raffaele Borghi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Replacements ◽  
Hip Diseases

Introduction The outcomes of total hip replacement in patients suffering from residual poliomyelitis are poorly covered in the literature. In this retrospective study we posed the question of whether total hip replacement performed for degenerative hip diseases in limbs with residual poliomyelitis could determine satisfactory mid-term clinical and radiographic results, with a reasonable complication rate. Methods A retrospective study was carried out to assess the results of 14 total hip replacements performed on 14 patients with residual poliomyelitis on the involved limb from June 1999 to September 2011. Average age at the time of surgery was 51 years (range 26-66 years). Mean duration of follow-up was 92 months (range 52-156 months). Surgery was performed through a direct lateral approach on all hips. All but one were cementless implants. Results 2 implants failed, 1 due to traumatic acetabular fracture 6 days after surgery, and 1 due to aseptic cup loosening 13 years after surgery. Surgery was uneventful in all patients except 1 (7%), who experienced a transient sensory sciatic nerve palsy. At the latest follow up Harris Hip Score was 83.3 (range 72-91) with a marked improvement when compared to preoperative score (average 52, range 32-78). No dislocations had occurred. Conclusions Total hip replacement can be considered a feasible option for hip osteoarthritis in patients with limbs affected by residual poliomyelitis. Longer follow-up studies are needed to assess the effectiveness of unconstrained total hip replacement in polio patients.

Sign in / Sign up

Export Citation Format

Share Document