A comparative study of patients presenting for planned and unplanned revision hip or knee arthroplasty
| العنوان: | A comparative study of patients presenting for planned and unplanned revision hip or knee arthroplasty |
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| المؤلفون: | Kingsbury, SR, Smith, LK, Shuweihdi, F, West, R, Czoski Murray, C, Conaghan, PG, Stone, MH |
| المصدر: | The Bone & Joint Journal |
| بيانات النشر: | British Editorial Society of Bone and Joint Surgery, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Male, Reoperation, Arthroplasty, Replacement, Hip, Operative Time, Arthroplasty, hips, Postoperative Complications, Return to Work, Risk Factors, primary surgery, Humans, Revision Knee Arthroplasty, Orthopedics and Sports Medicine, Knee, Centre for Health and Clinical Research, infections, Arthroplasty, Replacement, Knee, Propensity Score, Revision Hip Arthroplasty, Aged, Hip, Surveillance, knees, hip and knee arthroplasty, propensity score matching, Activity Level, revision surgeries, Length of Stay, Cross-Sectional Studies, hip hemiarthroplasty, Surgery, Female, periprosthetic fractures, unicompartmental knee arthroplasty |
| الوصف: | Aims The aim of this study was to conduct a cross-sectional, observational cohort study of patients presenting for revision of a total hip, or total or unicompartmental knee arthroplasty, to understand current routes to revision surgery and explore differences in symptoms, healthcare use, reason for revision, and the revision surgery (surgical time, components, length of stay) between patients having regular follow-up and those without. Methods Data were collected from participants and medical records for the 12 months prior to revision. Patients with previous revision, metal-on-metal articulations, or hip hemiarthroplasty were excluded. Participants were retrospectively classified as ‘Planned’ or ‘Unplanned’ revision. Multilevel regression and propensity score matching were used to compare the two groups. Results Data were analyzed from 568 patients, recruited in 38 UK secondary care sites between October 2017 and October 2018 (43.5% male; mean (SD) age 71.86 years (9.93); 305 hips, 263 knees). No significant inclusion differences were identified between the two groups. For hip revision, time to revision > ten years (odds ratio (OR) 3.804, 95% confidence interval (CI) (1.353 to 10.694), p = 0.011), periprosthetic fracture (OR 20.309, 95% CI (4.574 to 90.179), p < 0.001), and dislocation (OR 12.953, 95% CI (4.014 to 41.794), p < 0.001), were associated with unplanned revision. For knee, there were no associations with route to revision. Revision after ten years was more likely for those who were younger at primary surgery, regardless of route to revision. No significant differences in cost outcomes, length of surgery time, and access to a health professional in the year prior to revision were found between the two groups. When periprosthetic fractures, dislocations, and infections were excluded, healthcare use was significantly higher in the unplanned revision group. Conclusion Differences between characteristics for patients presenting for planned and unplanned revision are minimal. Although there was greater healthcare use in those having unplanned revision, it appears unlikely that routine orthopaedic review would have detected many of these issues. It may be safe to disinvest in standard follow-up provided there is rapid access to orthopaedic review. Cite this article: Bone Joint J 2022;104-B(1):59–67. |
| وصف الملف: | application/pdf; PDF |
| اللغة: | English |
| تدمد: | 2049-4394 2049-4408 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bdfd5320b819559427c8fcfe5875c449Test https://eprints.whiterose.ac.uk/182347/3/0301-620x.104b1.bjj-2021-0032.r2.pdfTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....bdfd5320b819559427c8fcfe5875c449 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20494394 20494408 |
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