Background
Methods
Patients and study design
Surgical information
Clinical evaluations
Questionnaire
Statistical analyses
Results
Patient information
H group (n = 32 hips) | Control (n = 64 hips) | P-value | FO group (n = 15 hips) | N-FO group (n = 15 hips) | P-value | |
---|---|---|---|---|---|---|
Number of patients | 23 | 46 | – | 10 | 12 | – |
Sex (male/female) | 2/21 | 4/42 | 0.686 | 2/8 | 0/12 | 0.195 |
Unilateral/bilateral | 14/9 | 28/18 | 1.000 | 5/5 | 9/3 | 0.221 |
Age (years) | 65.3 ± 6.3 | 64.5 ± 8.4 | 0.864 | 69.3 ± 4.5 | 60.8 ± 6.2 | 0.002 |
Height (cm) | 146.1 ± 6.5 | 157.3 ± 10.4 | <0.001 | 142.8 ± 6.4 | 150.6 ± 5.4 | 0.007 |
Weight (kg) | 47.9 ± 8.2 | 58.2 ± 12.4 | <0.001 | 48.0 ± 12.0 | 48.8 ± 7.1 | 0.849 |
BMI (kg/m2) | 22.0 ± 3.4 | 23.5 ± 3.2 | 0.202 | 23.5 ± 5.4 | 21.5 ± 2.8 | 0.284 |
Diagnosis (number of hips) | ||||||
Dysplasia | 31 | 64 | 0.333 | 14 | 15 | 0.500 |
Other | 1 | 0 | 0.333 | 1 | 0 | 0.500 |
Average follow-up period (years) | 5.8 ± 2.6 | 5.4 ± 2.4 | 0.557 | 5.4 ± 2.8 | 6.3 ± 2.8 | 0.443 |
Intraoperative blood loss (mL) | 465.9 ± 295.6 | 245.5 ± 143.0 | <0.001 | 596.0 ± 363.9 | 355.0 ± 212.1 | 0.067 |
Surgery time (min) | 252.4 ± 108.0 | 149.5 ± 28.3 | <0.001 | 350.0 ± 124.4 | 177.7 ± 42.8 | 0.002 |
LLD-preoperative (mm) | 24.9 ± 13.9 | 8.1 ± 5.6 | <0.001 | 31.9 ± 16.0 | 18.4 ± 10.0 | 0.026 |
LLD-postoperative (mm) | 9.4 ± 7.7 | 3.0 ± 2.1 | 0.041 | 12.5 ± 9.4 | 7.5 ± 5.6 | 0.140 |
Complications | ||||||
Infection | 2 | 0 | 0.109 | 0 | 2 | 0.286 |
Dislocation | 1 | 1 | 0.716 | 1 | 0 | 0.455 |
Intraoperative fracture | 0 | 1 | 0.536 | 0 | 0 | – |
Preoperative JOA score (points) | ||||||
Pain | 15.5 ± 7.0 | 16.1 ± 6.5 | 0.670 | 15.7 ± 7.9 | 16.0 ± 6.1 | 0.903 |
ROM | 10.8 ± 4.7 | 12.4 ± 4.0 | 0.081 | 12.4 ± 5.2 | 9.4 ± 3.6 | 0.056 |
Gait | 8.4 ± 2.9 | 9.3 ± 3.4 | 0.242 | 8.0 ± 2.5 | 9.9 ± 3.3 | 0.559 |
ADL | 10.9 ± 3.9 | 11.3 ± 3.5 | 0.641 | 10.8 ± 4.3 | 11.1 ± 3.6 | 0.931 |
Total | 45.8 ± 11.1 | 49.3 ± 10.6 | 0.139 | 47.1 ± 12.0 | 45.2 ± 10.4 | 0.579 |
Postoperative JOA score (points) | ||||||
Pain | 37.2 ± 3.0 | 37.7 ± 3.3 | 0.439 | 37.23 ± 3.1 | 37.3 ± 3.1 | 1.000 |
ROM | 17.4 ± 2.6 | 18.0 ± 2.6 | 0.309 | 17.1 ± 3.3 | 17.7 ± 1.8 | 0.596 |
Gait | 16.6 ± 3.8 | 17.6 ± 3.0 | 0.191 | 15.8 ± 5.0 | 17.7 ± 2.2 | 0.330 |
ADL | 16.3 ± 4.1 | 17.6 ± 2.7 | 0.096 | 15.5 ± 4.8 | 17.1 ± 3.4 | 0.314 |
Total | 87.4 ± 9.1 | 90.8 ± 8.7 | 0.080 | 85.7 ± 10.5 | 89.2 ± 7.7 | 0.327 |
Postoperative SF-36 (points) | ||||||
PF | 73.3 ± 19.7 | 70.1 ± 22.3 | 0.568 | 75.0 ± 14.7 | 71.7 ± 24.1 | 0.696 |
RP | 81.3 ± 19.8 | 79.2 ± 24.2 | 0.728 | 82.9 ± 16.8 | 79.7 ± 22.9 | 0.705 |
BP | 72.0 ± 22.5 | 63.6 ± 23.2 | 0.158 | 71.0 ± 21.5 | 72.9 ± 24.4 | 0.844 |
GH | 59.2 ± 19.3 | 60.5 ± 16.7 | 0.780 | 59.2 ± 19.3 | 60.5 ± 16.7 | 0.624 |
VT | 66.6 ± 19.0 | 65.9 ± 15.4 | 0.875 | 68.8 ± 18.3 | 64.6 ± 20.2 | 0.610 |
SF | 88.6 ± 18.8 | 87.2 ± 17.0 | 0.763 | 89.8 ± 9.4 | 87.5 ± 25.0 | 0.780 |
RE | 83.0 ± 21.2 | 83.0 ± 21.3 | 1.000 | 86.4 ± 20.2 | 79.9 ± 22.6 | 0.477 |
MH | 72.2 ± 20.7 | 77.5 ± 15.1 | 0.228 | 71.4 ± 21.8 | 72.9 ± 20.6 | 0.862 |
Complications
PROMs
Groups | Promoters | Passives | Detractors | NPS |
---|---|---|---|---|
H group (n = 23) | 69.5% (n = 16) | 26.1% (n = 6) | 4.3% (n = 1) | 65 |
Control (n = 46) | 80.4% (n = 37) | 10.9% (n = 5) | 8.7% (n = 4) | 72 |
FO group (n = 10) | 70.0% (n = 7) | 20.0% (n = 2) | 10.0% (n = 1) | 60 |
N-FO group (n = 12) | 75.0% (n = 9) | 25.0% (n = 3) | 0% (n = 0) | 75 |
Questionnaire
H group (23 cases) | Control (46 cases) | P-value | FO group (10 cases) | N-FO group (12 cases) | P-value | |
---|---|---|---|---|---|---|
Q1. The reason for receiving THA | ||||||
1. Hip pain | 19 | 41 | 0.468 | 7 | 11 | 0.293 |
2. Other pain | 9 | 14 | 0.470 | 6 | 3 | 0.192 |
3. Walking disorder | 18 | 40 | 0.487 | 8 | 9 | 1.000 |
4. LLD | 13 | 9 | 0.002 | 5 | 8 | 0.666 |
5. Limits on ROM at hip joint | 16 | 27 | 0.380 | 7 | 8 | 1.000 |
Q2. Primary complaint | ||||||
1. Hip pain | 15 | 32 | 0.715 | 6 | 8 | 0.546 |
2. Other pain | 0 | 3 | 0.546 | 0 | 0 | – |
3. Walking disorder | 6 | 5 | 0.161 | 4 | 2 | 0.348 |
4. LLD | 1 | 0 | 0.333 | 0 | 1 | 0.545 |
5. Limits on ROM at hip joint | 1 | 6 | 0.411 | 0 | 1 | 0.545 |
Q3. Satisfaction following THA | ||||||
Points | 90.3 ± 11.3 | 91.5 ± 12.5 | 0.680 | 84.8 ± 13.2 | 94.0 ± 6.6 | 0.057 |
Rates, % (n/N) | 95.6 (22/23) | 93.5 (43/46) | 0.593 | 90.0 (9/10) | 100.0 (12/12) | 0.455 |
Q4. Benefits of THA | ||||||
1. Hip pain subsided | 19 | 43 | 0.211 | 7 | 11 | 0.226 |
2. Other pain subsided | 6 | 12 | 0.071 | 3 | 3 | 0.583 |
3. Walking disorder improved | 16 | 38 | 0.216 | 6 | 9 | 0.652 |
4. LLD improved | 12 | 9 | 0.006 | 5 | 7 | 0.515 |
5. ROM improved | 12 | 32 | 0.157 | 4 | 7 | 0.392 |
Q5. Best outcome | ||||||
1. Hip pain subsided | 13 | 29 | 0.601 | 6 | 7 | 0.639 |
2. Other pain subsided | 1 | 3 | 0.892 | 0 | 1 | 0.545 |
3. Walking disorder improved | 6 | 8 | 0.527 | 2 | 3 | 0.594 |
4. LLD improved | 2 | 0 | 0.108 | 1 | 1 | 0.714 |
5. ROM improved | 1 | 6 | 0.411 | 1 | 0 | 0.455 |
Q6. Adverse outcomes | ||||||
1. Hip pain worsened | 0 | 1 | 0.667 | 0 | 0 | – |
2. Other pain worsened | 3 | 4 | 0.435 | 1 | 2 | 0.571 |
3. Walking disorder worsened | 3 | 4 | 0.435 | 2 | 0 | 0.195 |
4. LLD worsened | 0 | 1 | 0.667 | 0 | 0 | – |
5. Limits on ROM worsened | 0 | 3 | 0.290 | 0 | 0 | – |
6. None | 17 | 33 | 0.544 | 7 | 10 | 0.229 |
Q7. Worst outcome | ||||||
1. Hip pain worsened | 0 | 1 | 0.667 | 0 | 0 | – |
2. Other pain worsened | 3 | 4 | 0.435 | 2 | 1 | 0.429 |
3. Walking disorder worsened | 3 | 4 | 0.435 | 2 | 0 | 0.195 |
4. LLD worsened | 0 | 1 | 0.667 | 0 | 0 | – |
5. Limits on ROM worsened | 0 | 3 | 0.290 | 0 | 0 | – |
6. None | 17 | 33 | 0.544 | 6 | 11 | 0.105 |
Q8. Social problems after THA | ||||||
1. High treatment cost | 2 | 2 | 0.596 | 0 | 2 | 0.286 |
2. Long length of stay | 4 | 2 | 0.09 | 2 | 2 | 0.632 |
3. Serious rehabilitation | 10 | 8 | 0.02 | 7 | 2 | 0.017 |
4. Difficult return to work | 0 | 4 | 0.293 | 0 | 0 | – |
5. None | 13 | 32 | 0.284 | 3 | 8 | 0.099 |
Q9. Worst social problem after THA | ||||||
1. High treatment cost | 0 | 1 | 0.667 | 0 | 0 | – |
2. Long length of stay | 2 | 2 | 0.596 | 0 | 2 | 0.286 |
3. Serious rehabilitation | 10 | 7 | 0.01 | 7 | 2 | 0.017 |
4. Difficult return to work | 0 | 4 | 0.293 | 0 | 0 | – |
5. None | 11 | 32 | 0.079 | 3 | 8 | 0.099 |
Q10. Walking indoors | ||||||
1. No cane | 20 | 44 | 0.202 | 7 | 12 | 0.078 |
2. Cane | 3 | 2 | 0.202 | 3 | 0 | 0.078 |
3. A walker | 0 | 0 | – | 0 | 0 | – |
4. Wheelchair | 0 | 0 | – | 0 | 0 | – |
5. Not walking | 0 | 0 | – | 0 | 0 | – |
Q11. Walking outdoors | ||||||
1. No cane | 18 | 38 | 0.465 | 6 | 11 | 0.105 |
2. Cane | 4 | 8 | 0.640 | 3 | 1 | 0.226 |
3. A walker | 1 | 0 | 0.333 | 1 | 0 | 0.455 |
4. Wheelchair | 0 | 0 | – | 0 | 0 | – |
5. Not walking | 0 | 0 | – | 0 | 0 | – |
Q12. VAS score (mm) | 14.2 ± 12.9 | 9.3 ± 7.5 | 0.036 | 23.1 ± 14.4 | 6.2 ± 8.0 | 0.001 |
Q13. THA was still the best choice? | ||||||
1. Yes | 20 | 39 | 0.559 | 8 | 11 | 0.571 |
2. Not sure | 3 | 5 | 0.538 | 2 | 1 | 0.571 |
3. No | 0 | 2 | 0.441 | 0 | 0 | – |