Do different types of bearings and noise from total hip arthroplasty influence hip-related pain, function, and quality of life postoperatively?
Background and purpose - Patient-reported outcome (PRO) is recognized as an important tool for evaluating the outcome and satisfaction after total hip arthroplasty (THA). We wanted to compare patient-reported outcome measure (PROM) scores from patients with ceramic-on-ceramic (CoC) THAs and those with metal-on-metal (MoM) THAs to scores from patients with metal-on-polyethylene (MoP) THAs, and to determine the influence of THA-related noise on PROM scores. Patients and methods - We conducted a nationwide cross-sectional questionnaire survey in a cohort of patients identified from the Danish Hip Arthroplasty Registry. The PROMs included were: hip dysfunction and osteoarthritis and outcome score (HOOS), EQ-5D-3L, EQ VAS, UCLA activity score, and questions about noise from the THA. The response rate was 85% and the number of responders was 3,089. Of these, 45% had CoC THAs, 17% had MoM THAs, and 38% had MoP THAs, with a mean length of follow-up of 7, 5, and 7 years, respectively. Results - Compared to MoP THAs, the mean PROM scores for CoC and MoM THAs were similar, except that CoC THAs had a lower mean score for HOOS Symptoms than did MoP THA. 27% of patients with CoC THAs, 29% with MoM THAs, and 12% with MoP THAs reported noise from their hip. For the 3 types of bearings, PROM scores from patients with a noisy THA were statistically significantly worse than those from patients with a silent MoP THA. The exception was noisy CoC and MoM THAs, which had the same mean UCLA activity score as silent MoP THAs. Interpretation - A high proportion of patients reported noise from the THA, and these patients had worse PROM scores than patients with silent MoP THAs.
a Department of Orthopaedic Surgery, Section for Hip and Knee Replacement , Vejle Hospital , Vejle.|b Department of Clinical Research, Faculty of Health Sciences , University of Southern Denmark , Odense.|c Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense.
Claus
C
Varnum
d Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
Alma B
AB
Pedersen
a Department of Orthopaedic Surgery, Section for Hip and Knee Replacement , Vejle Hospital , Vejle.
Per
P
Kjærsgaard-Andersen
b Department of Clinical Research, Faculty of Health Sciences , University of Southern Denmark , Odense.|c Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense.
Søren
S
Overgaard
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009622:Noise; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires