Influence of preoperative variables on total hip arthroplasty results

Barrera-Cadenas, J.L.; Hernández-Vaquero, D.

doi:10.1016/S1988-8856(11)70288-7

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Abstract

Objective

To evaluate the influence of certain preoperative variables (comorbidity, gender, age, aetiology, marital status or surgeon) on the results of the total hip arthroplasty (THA), and also to find out if there is agreement between the opinion of the patient and the surgeon when the final result is obtained.

Material and methods

The results of 100 of the same type of THA were analysed retrospectively using three methods: a clinical evaluation scale (Johnston protocol); the SF-36 quality of life scale, and a visual analogue scale that could assess the differences in scoring between the patient and the surgeon for the residual pain and the satisfaction obtained.

Results

The age, the sex of the patient or the type of arthrosis did not influence the final result (p>.05). Married patients presented a greater vitality (p=.01) than those not married, and those with greater preoperative comorbidity had more social activity after the surgery (p=.04). The patients showed more pain and less satisfaction than those noted by the surgeon, with more striking significant differences (p<.05) in the group of patients who showed higher levels of pain and lower levels of satisfaction with a significant linear regression (p<.05).

Discussion

We have found a discrepancy in the evaluation of the results of total hip arthroplasties between the surgeon and the patient, particularly regarding the residual pain, the more pain there was the less satisfied was the patient. In general, it could be said that the surgeon is happier with the result of the procedure than the patient.

Keywords:

Total hip arthroplasty

Outcomes

Health-related quality of life

Resumen

Objetivo

Valorar la influencia de determinadas variables preoperatorias (comorbilidad, sexo, edad, etiología, estado civil o cirujano) en los resultados de las artroplastias totales de cadera y comparar si hay concordancia entre la opinión del paciente y del cirujano en cuanto al resultado obtenido.

Material y método

Hemos analizado retrospectivamente los resultados de 100 artroplastias totales de cadera del mismo modelo, mediante tres sistemas de evaluación: el protocolo de Johnston, el SF-36 y una escala analógica visual que permitió valorar las diferencias entre el paciente y el cirujano en cuanto al dolor residual y la satisfacción obtenida.

Resultados

La edad, el sexo del paciente o el tipo de artrosis no influyeron en el resultado final (p > 0,05). Los pacientes casados presentaron una mayor vitalidad (p = 0,01) que los no casados y aquellos con mayor comorbilidad preoperatoria tuvieron mayor función social tras la cirugía (p = 0,04). Los pacientes mostraron más dolor y menor satisfacción que los anotados por su cirujano, con diferencias significativas (p < 0,05) más llamativas en los pacientes que mostraban niveles más altos de dolor y más bajos de satisfacción con una regresión lineal significativa (p < 0,05).

Discusión

Determinadas variables pueden modificar los resultados de las artroplastias de cadera. Existe una discordancia en la valoración de los resultados de las artroplastias de cadera entre paciente y cirujano, mayor cuanto más elevado es el dolor o menor la satisfacción del paciente. El cirujano valora mejor el resultado del procedimiento que el propio paciente.

Palabras clave:

Artroplastia total de cadera

Valoración de resultados

Calidad de vida

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