Patient-reported outcome of 95% of young patients improves after primary total hip arthroplasty: identification of 3 recovery trajectories in 3,207 patients younger than 55 years from the Dutch Arthroplasty Register

Authors

  • Martijn F L Kuijpers Department of Orthopaedics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen
  • Liza N van Steenbergen Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten), ‘s Hertogenbosch https://orcid.org/0000-0002-8141-842X
  • B Willem Schreurs Department of Orthopaedics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen; Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten), ‘s Hertogenbosch https://orcid.org/0000-0003-4518-431X
  • Gerjon Hannink Department of Operating Rooms, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands https://orcid.org/0000-0001-9526-3775

DOI:

https://doi.org/10.2340/17453674.2022.3140

Keywords:

Hip, Patient reported outcome, Young patients

Abstract

Background and purpose: Little is known about the outcome after receiving total hip arthroplasty (THA), specifically in young patients. We identified different recovery trajectories in young patients using data from the Dutch Arthroplasty Register (LROI). We also explored whether risk factors commonly associated with functional outcome were associated with recovery trajectory.
Patients and methods: We used HOOS-PS score data up to 1 year postoperatively from the LROI from all patients younger than 55 years who received a primary THA between 2014 and 2019. To investigate whether different recovery trajectories could be distinguished, we performed latent class growth analysis (LCGA). Subsequently, we used multinomial logistic regression analyses to explore factors associated with class membership.
Results: 3,207 patients were included. LCGA identified 3 groups of patients: optimal responders (75%), good responders (21%), and poor responders (4.7%). Female sex (RR 1.1; 95% CI 1.1–1.1), ASA II (RR 1.1; CI 1.0–1.1), ASA III–IV (RR 1.1; CI 1.0–1.2), smoking (RR 1.1; CI 1.0–1.1), cemented fixation (RR 1.2; CI 1.1–1.2), and a 22–28 mm head diameter (RR 1.1; CI 1.0–1.2) were associated with “good responder” class membership. ASA II (RR 1.1; 1.0–1.2), ASA III–IV (RR 1.2; 1.1–1.3), smoking (RR 1.2; CI 1.1–1.2), and hybrid fixation (RR 1.2; CI 1.0–1.2) were associated with “poor responder” class membership.
Interpretation: 3 recovery trajectories could be identified. Female sex, higher ASA classifications, smoking, cemented or hybrid fixation, and small head diameter were associated with a suboptimal result after primary THA in young patients. These findings can aid in the process to determine which patients are at risk of a suboptimal outcome.

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Published

2022-06-20

How to Cite

Kuijpers, M. F. L., van Steenbergen, L. N., Schreurs, B. W., & Hannink, G. (2022). Patient-reported outcome of 95% of young patients improves after primary total hip arthroplasty: identification of 3 recovery trajectories in 3,207 patients younger than 55 years from the Dutch Arthroplasty Register. Acta Orthopaedica, 93, 560–567. https://doi.org/10.2340/17453674.2022.3140

Issue

Section

National/international register study