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Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition

  • Original Article
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HSS Journal ®

Abstract

Background

Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of life.

Questions/Purposes

We sought to determine if any difference in quality of life measures could be detected in patients treated with total hip replacement implanted with cobalt-chrome (CoCr) versus ceramic femoral heads at 2-year follow-up.

Methods

We compared the hip disability and osteoarthritis outcome score (HOOS) and EuroQOL (EQ5D) scores of a matched set of patients that underwent primary total hip arthroplasty with highly cross-linked polyethylene (HXLPE) and a single implant system consisting of either a metal or a ceramic femoral head.

Results

Clinical outcomes and quality of life improved for both groups after hip replacement surgery. Patients with a ceramic head showed greater improvement than those with a metal head in HOOS pain and EQ5D VAS scores by a statistically significant margin (p = 0.0417 and 0.019, respectively), but the differences between the HOOS and EQ5D VAS scores (3.4 and 0.04, respectively) do not demonstrate a clinically significant difference.

Conclusions

We found that the femoral head composition has no effect on clinical outcomes or patient quality of life at 2 years.

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References

  1. Clarke IC, Gustafson A. Clinical and hip simulator comparisons of ceramic-on-polyethylene and metal-on-polyethylene wear. Clin Orthop Relat Res. 2000; 379: 34-40.

    Article  PubMed  Google Scholar 

  2. Ehrich EW, Davies GM, Watson DJ, Bolognese JA, Seidenberg BC, Bellamy N. Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol. 2000; 27–11: 2635.

    Google Scholar 

  3. Hadley Callaway G, Flynn W, Ranawat CS, Sculco TP. Fracture of the femoral head after ceramic-on-polyethylene total hip arthroplasty. J Arthroplast. 1995; 10–6: 855-9.

    Article  Google Scholar 

  4. Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring Health-Related Quality of Life in Rheumatoid Arthritis: Validity, Responsiveness, and Reliability of EuroQOL EQ-5D. Br J Rheumatol. 1997; 36: 551-559.

    Article  CAS  PubMed  Google Scholar 

  5. McKenzie L, van der Pol M. Mapping the EORTC QLQ C-30 onto the EQ-5D Instrument: The Potential to Estimate QALYs without Generic Preference Data. Value Health. 2009; 12(1): 167-171.

    Article  PubMed  Google Scholar 

  6. Nikolaou V, Edwards M, Bogoch E, Schemitsch E, Waddell J. A prospective randomised controlled trial comparing three alternative bearing surfaces in primary total hip replacement. J Bone Joint Surg. 2012; 94–4: 459-65. British Volum.

    Article  Google Scholar 

  7. Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS)–validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003; 4–1: 10.

    Article  Google Scholar 

  8. Normand S-LT, Landrum MB, Guadagnoli E, et al. Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores. J Clin Epidemiol. 2001; 54–4: 387-98.

    Article  Google Scholar 

  9. Rosenbaum PR, Rubin DB. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat. 1985; 39–1: 33-8.

    Google Scholar 

  10. Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983; 70–1: 41-55.

    Article  Google Scholar 

  11. Urban JA, Garvin KL, Boese CK, et al. Ceramic-on-Polyethylene Bearing Surfaces in Total Hip Arthroplasty Seventeen to Twenty-one-Year Results. J Bone Joint Surg. 2001; 83–11: 1688-94.

    Google Scholar 

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Disclosures

Conflict of Interest

Michael P. Ast, MD, Stephen Lyman, PhD, Alexandra H. Gorab, BS, Natalie Parkes, BA, John Boles, BS, and Yuo-yu Lee, MS have declared that they have no conflict of interest. Geoffrey H. Westrich, MD reports grants and personal fees from Stryker Orthopedics and Exactech; grants from DJO; committee member of the Knee Society and a board member of the Eastern Orthopedic Association, outside the work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Michael P. Ast MD, Alexandra H. Gorab BS, Natalie Parkes BA, John Boles BS & Geoffrey H. Westrich MD

  2. Hospital for Special Surgery, New York, NY, USA

    Stephen Lyman PhD & Yuo-yu Lee MS

Authors
  1. Michael P. Ast MD
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  2. Stephen Lyman PhD
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  3. Alexandra H. Gorab BS
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  4. Natalie Parkes BA
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  5. John Boles BS
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  6. Yuo-yu Lee MS
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  7. Geoffrey H. Westrich MD
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Corresponding author

Correspondence to Geoffrey H. Westrich MD.

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Level of Evidence

Therapeutic Study Level III

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Ast, M.P., Lyman, S., Gorab, A.H. et al. Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition. HSS Jrnl 11, 130–135 (2015). https://doi.org/10.1007/s11420-015-9433-0

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  • DOI: https://doi.org/10.1007/s11420-015-9433-0

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