Quality of life after hip revision with impaction bone grafting on a par with that 4 years after primary cemented arthroplasty.
BACKGROUND
There have been few studies evaluating patient-reported quality of life outcomes after hip revision with impaction bone grafting.


METHODS
The inclusion criteria were aseptic loosening after primary arthroplasty performed for osteoarthrosis, and first-time revision with impacted morselized allograft bone and cemented Exeter stem. During a 4-year period, 35 patients were eligible and all were included. The Nottingham Health Profile (NHP) was completed by the patients and the Charnley hip scores recorded by the examining surgeon preoperatively, after 6 months and yearly up to 4 years (28 patients) postoperatively. For comparison, 35 osteoarthrotic patients completed the NHP 4 years after cemented Exeter primary arthroplasty.


RESULTS
At 4 years, the NHP scores for the revision patients did not differ significantly from those recorded in the primary arthroplasty group. Among the revision patients, mixed model analysis showed improvement in NHP pain (p < 0.001) and physical mobility scores (p = 0.002). The effect size at 4 years was large for pain (1.2) and moderate for physical mobility (0.6). The major improvement was recorded at 6 months, with no further substantial change observed. The correlations between the NHP and Charnley scores were weak or moderate (r, -0.15 to -0.67).


CONCLUSIONS
Hip revision with impaction bone grafting leads to substantially improved quality of life, similar to that 4 years after primary arthroplasty.
Atroshi
Isam
I
Department of Orthopedics, Hässleholm-Kristianstad Hospitals, SE-281 25 Hässleholm, Sweden. isam.atroshi@mailbox.swipnet.se
Ornstein
Ewald
E
Franzén
Herbert
H
Johnsson
Ragnar
R
Stefánsdóttir
Anna
A
Sundberg
Martin
M
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000523:psychology; D001843:Bone Cements; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement; D011446:Prospective Studies; D011475:Prosthesis Failure; D011788:Quality of Life; D012086:Reoperation; D012649:Self Concept; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D001843:Bone Cements