TY - JOUR
T1 - Patient-Reported Outcomes Following Total Hip Arthroplasty
T2 - A Multicenter Comparison Based on Surgical Approaches
AU - The PEPPER Investigators
AU - Finch, Daniel J.
AU - Martin, Brook I.
AU - Franklin, Patricia D.
AU - Magder, Laurence S.
AU - Pellegrini, Vincent D.
N1 - Funding Information:
Collaborators: The PEPPER Trial Investigators. Funding/Support: The research reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (PCS-1402-09328) for the PEPPER trial, and through an Agency for Healthcare Research and Quality Award (R01HS024714) for the analysis. The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of PCORI, AHRQ, or their Board of Governors or Methodology Committees.
Funding Information:
Collaborators: The PEPPER Trial Investigators. Funding/Support: The research reported in this article was funded through a P atient-Centered Outcomes Research Institute (PCORI) Award ( PCS-1402-09328 ) for the PEPPER trial, and through an Agency for Healthcare Research and Quality Award ( R01HS024714 ) for the analysis. The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of PCORI, AHRQ, or their Board of Governors or Methodology Committees. Appendix
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Background: Comparisons of patient-reported outcomes (PROs) based on surgical approach for total hip arthroplasty (THA) in the United States are limited to series from single surgeons or institutions. Using prospective data from a large, multicenter study, we compare preoperative to postoperative changes in PROs between posterior, transgluteal, and anterior surgical approaches to THA. Methods: Patient-reported function, global health, and pain were systematically collected preoperatively and at 1, 3, and 6 months postoperatively from patients undergoing primary THA at 26 sites participating in the Comparative Effectiveness of Pulmonary Embolism Prevention After Hip and Knee Replacement (ClinicalTrials.gov: NCT02810704). Outcomes consisted of the brief Hip disability and Osteoarthritis Outcome Score, the Patient-Reported Outcomes Measurement Information System Physical Health score, and the Numeric Pain Rating Scale. Operative approaches were grouped by surgical plane relative to the abductor musculature as being either anterior, transgluteal, or posterior. Results: Between 12/12/2016 and 08/31/2019, outcomes from 3018 eligible participants were examined. At 1 month, the transgluteal cohort had a 2.2-point lower improvement in Hip disability and Osteoarthritis Outcomes Score (95% confidence interval, 0.40-4.06; P =.017) and a 1.3-point lower improvement in Patient-Reported Outcomes Measurement Information System Physical Health score (95% confidence interval, 0.48-2.04; P =.002) compared to posterior approaches. There was no significant difference in improvement between anterior and posterior approaches. At 3 and 6 months, no clinically significant differences in PRO improvement were observed between groups. Conclusion: PROs 6 months following THA dramatically improved regardless of the plane of surgical approach, suggesting that choice of surgical approach can be left to the discretion of surgeons and patients without fear of differential early outcomes.
AB - Background: Comparisons of patient-reported outcomes (PROs) based on surgical approach for total hip arthroplasty (THA) in the United States are limited to series from single surgeons or institutions. Using prospective data from a large, multicenter study, we compare preoperative to postoperative changes in PROs between posterior, transgluteal, and anterior surgical approaches to THA. Methods: Patient-reported function, global health, and pain were systematically collected preoperatively and at 1, 3, and 6 months postoperatively from patients undergoing primary THA at 26 sites participating in the Comparative Effectiveness of Pulmonary Embolism Prevention After Hip and Knee Replacement (ClinicalTrials.gov: NCT02810704). Outcomes consisted of the brief Hip disability and Osteoarthritis Outcome Score, the Patient-Reported Outcomes Measurement Information System Physical Health score, and the Numeric Pain Rating Scale. Operative approaches were grouped by surgical plane relative to the abductor musculature as being either anterior, transgluteal, or posterior. Results: Between 12/12/2016 and 08/31/2019, outcomes from 3018 eligible participants were examined. At 1 month, the transgluteal cohort had a 2.2-point lower improvement in Hip disability and Osteoarthritis Outcomes Score (95% confidence interval, 0.40-4.06; P =.017) and a 1.3-point lower improvement in Patient-Reported Outcomes Measurement Information System Physical Health score (95% confidence interval, 0.48-2.04; P =.002) compared to posterior approaches. There was no significant difference in improvement between anterior and posterior approaches. At 3 and 6 months, no clinically significant differences in PRO improvement were observed between groups. Conclusion: PROs 6 months following THA dramatically improved regardless of the plane of surgical approach, suggesting that choice of surgical approach can be left to the discretion of surgeons and patients without fear of differential early outcomes.
KW - HOOS
KW - anterior
KW - hip arthroplasty
KW - patient-reported outcomes
KW - posterior
KW - transgluteal
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U2 - 10.1016/j.arth.2019.10.017
DO - 10.1016/j.arth.2019.10.017
M3 - Article
C2 - 31926776
AN - SCOPUS:85077684676
SN - 0883-5403
VL - 35
SP - 1029-1035.e3
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 4
ER -