When does patient function "Plateau" after total joint arthroplasty? A cohort study.

Autor: Ekhtiari S; Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, UK., Worthy T; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON , Canada., Winemaker MJ; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON , Canada.; Hamilton Arthroplasty Group, Hamilton Health Sciences, Juravinski Hospital, 711 Concession Street B1-12 Hamilton, Ontario, L8V 1C3, Canada., de V Beer J; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON , Canada.; Hamilton Arthroplasty Group, Hamilton Health Sciences, Juravinski Hospital, 711 Concession Street B1-12 Hamilton, Ontario, L8V 1C3, Canada., Petruccelli DT; Hamilton Arthroplasty Group, Hamilton Health Sciences, Juravinski Hospital, 711 Concession Street B1-12 Hamilton, Ontario, L8V 1C3, Canada., Khanduja V; Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, UK., Citak M; Department of Orthopaedic Surgery, Helios ENDO Klinik Hamburg, Hamburg, Germany., Puri L; Hamilton Arthroplasty Group, Hamilton Health Sciences, Juravinski Hospital, 711 Concession Street B1-12 Hamilton, Ontario, L8V 1C3, Canada. puri@hhsc.ca., Wood TJ; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON , Canada.; Hamilton Arthroplasty Group, Hamilton Health Sciences, Juravinski Hospital, 711 Concession Street B1-12 Hamilton, Ontario, L8V 1C3, Canada.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2024 Sep; Vol. 48 (9), pp. 2283-2291. Date of Electronic Publication: 2024 Jul 15.
DOI: 10.1007/s00264-024-06248-8
Abstrakt: Purpose: With over 100,000 procedures completed per year, hip and knee arthroplasty are two of the most common surgical procedures performed in Canada. There has been literature indicating that patient reported outcome measures (PROM) will start to plateau between six and 12 months. The purpose of this paper was to analyze the trajectory of PROMs following total hip and knee arthroplasty (THA and TKA), as well as assess the impact of any potential confounders on this trajectory. The central research question was: At what point do PROMS plateau among patients that undergo elective THA and TKA?
Methods: This study was a retrospective analysis of data from a prospective database. Patients were eligible if they had undergone an elective, primary THA/TKA with Oxford Scores recorded pre-operatively, and at least at two of the following four time points: six weeks, six months, one year, and two years.
Results: Mean pre-operative Oxford scores were 18.0 (7.8) for THA, and 20.1 (7.5) for TKA. For both THA and TKA, there were statistically significant interval improvements in Oxford scores from six weeks [THA: 33.8 (7.9)/TKA: 28.7 (7.8)] to six months [THA: 40.2 (7.3)/TKA: 35.9 (8.3)], and from six months to one year [THA: 41.0 (7.3)/TKA: 37.3 (8.4)], but not from one to two years [THA: 40.0 (8.5)/TKA: 36.4 (9.6)].
Conclusions: Patients undergoing either primary THA or TKA can expect clinically meaningful improvements in the first six months after surgery. Beyond this time point, there is a plateau in PROMs. These findings are important for both setting patient expectations in pre-operative discussions, and allowing surgeons to have a realistic understanding of their patients' expected post-operative course.
(© 2024. The Author(s) under exclusive licence to SICOT aisbl.)
Databáze: MEDLINE
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