Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study
Background and purpose: There is little evidence on improvement after revision total hip replacement (THR). Moreover, improvements may be associated with socioeconomic status (SES). We investigated whether changes in Harris Hip Score (HHS) differ among patients undergoing primary and revision THR,...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2022-04-01
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| Series: | Acta Orthopaedica |
| Subjects: | |
| Online Access: | https://actaorthop.org/actao/article/view/2430 |
| _version_ | 1818348783146106880 |
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| author | Martin B Stisen André N Klenø Julie S Jacobsen Matthew D L O’Connell Salma Ayis Catherine Sackley Alma B Pedersen Inger Mechlenburg |
| author_facet | Martin B Stisen André N Klenø Julie S Jacobsen Matthew D L O’Connell Salma Ayis Catherine Sackley Alma B Pedersen Inger Mechlenburg |
| author_sort | Martin B Stisen |
| collection | DOAJ |
| description |
Background and purpose: There is little evidence on improvement after revision total hip replacement (THR). Moreover, improvements may be associated with socioeconomic status (SES). We investigated whether changes in Harris Hip Score (HHS) differ among patients undergoing primary and revision THR, and their association with markers of SES.
Patients and methods: We conducted a populationbased cohort study on 16,932 patients undergoing primary and/or revision THR from 1995 to 2018 due to hip osteoarthritis. The patients were identified in the Danish Hip Arthroplasty Registry. Outcome was defined as mean change in HHS (0–100) from baseline to 1-year follow-up, and its association with SES markers (education, cohabiting, and
wealth) was analyzed using multiple linear regression adjusting for sex, age, comorbidities, and baseline HHS.
Results: At 1-year follow-up, HHS improved clinically relevant for patients undergoing both primary THR: mean 43 (95% CI 43–43) and revision THR: mean 31 (CI 29–33); however, the increase was 12 points (CI 10–14) higher for primary THR. For primary THR, improvements were 0.9 points (CI 0.4–1.5) higher for patients with high educational level compared with low educational level, 0.4 points (CI 0.0–0.8) higher for patients cohabiting compared with living alone, and 2.6 points higher (CI 2.1–3.0) for patients with high wealth compared with low wealth.
Interpretation: Patients undergoing primary THR achieve higher improvements on HHS than patients undergoing revision THR, and the improvements are negatively related to markers of low SES. Health professionals should be aware of these characteristics and be able to identify patients who may benefit from extra rehabilitation to improve outcomes after THR to ensure equality in health.
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| first_indexed | 2024-12-13T17:55:32Z |
| format | Article |
| id | doaj.art-933ce0a8b2374a46986f74da9731a373 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-13T17:55:32Z |
| publishDate | 2022-04-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-933ce0a8b2374a46986f74da9731a3732022-12-21T23:36:23ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822022-04-019310.2340/17453674.2022.2430Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort studyMartin B Stisen0André N Klenø1Julie S Jacobsen2Matthew D L O’Connell3Salma Ayis4Catherine Sackley5Alma B Pedersen6Inger Mechlenburg7Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, DenmarkDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark; Research Unit for General Practice in Aarhus, Aarhus, DenmarkDepartment of Population Health Sciences, School of Population Health and Environmental Sciences, Kings College London, London, UKDepartment of Population Health Sciences, School of Population Health and Environmental Sciences, Kings College London, London, UKDepartment of Population Health Sciences, School of Population Health and Environmental Sciences, Kings College London, London, UKDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Background and purpose: There is little evidence on improvement after revision total hip replacement (THR). Moreover, improvements may be associated with socioeconomic status (SES). We investigated whether changes in Harris Hip Score (HHS) differ among patients undergoing primary and revision THR, and their association with markers of SES. Patients and methods: We conducted a populationbased cohort study on 16,932 patients undergoing primary and/or revision THR from 1995 to 2018 due to hip osteoarthritis. The patients were identified in the Danish Hip Arthroplasty Registry. Outcome was defined as mean change in HHS (0–100) from baseline to 1-year follow-up, and its association with SES markers (education, cohabiting, and wealth) was analyzed using multiple linear regression adjusting for sex, age, comorbidities, and baseline HHS. Results: At 1-year follow-up, HHS improved clinically relevant for patients undergoing both primary THR: mean 43 (95% CI 43–43) and revision THR: mean 31 (CI 29–33); however, the increase was 12 points (CI 10–14) higher for primary THR. For primary THR, improvements were 0.9 points (CI 0.4–1.5) higher for patients with high educational level compared with low educational level, 0.4 points (CI 0.0–0.8) higher for patients cohabiting compared with living alone, and 2.6 points higher (CI 2.1–3.0) for patients with high wealth compared with low wealth. Interpretation: Patients undergoing primary THR achieve higher improvements on HHS than patients undergoing revision THR, and the improvements are negatively related to markers of low SES. Health professionals should be aware of these characteristics and be able to identify patients who may benefit from extra rehabilitation to improve outcomes after THR to ensure equality in health. https://actaorthop.org/actao/article/view/2430Harris Hip ScoreOsteoarthritisPrimary Hip ReplacementRevision Hip ReplacementSocioeconomic Status |
| spellingShingle | Martin B Stisen André N Klenø Julie S Jacobsen Matthew D L O’Connell Salma Ayis Catherine Sackley Alma B Pedersen Inger Mechlenburg Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study Acta Orthopaedica Harris Hip Score Osteoarthritis Primary Hip Replacement Revision Hip Replacement Socioeconomic Status |
| title | Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study |
| title_full | Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study |
| title_fullStr | Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study |
| title_full_unstemmed | Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study |
| title_short | Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study |
| title_sort | do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status a 1 year population based cohort study |
| topic | Harris Hip Score Osteoarthritis Primary Hip Replacement Revision Hip Replacement Socioeconomic Status |
| url | https://actaorthop.org/actao/article/view/2430 |
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