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Clinical outcomes after hip resurfacing associated with commitment to rehabilitation
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LAS VEGAS — A new study links patients’ commitment to rehabilitation with functional outcomes and satisfaction following total hip resurfacing arthroplasty.
“We found that commitment to rehab correlates with improved function and satisfaction, a fact that has not specifically been discussed and not much looked at in the literature to date,” David R. Marker said during his presentation at the American Academy of Orthopaedic Surgeons 76th Annual Meeting, here.
“Obese patients are more likely to be less committed to rehabilitation. Surgeons should be aware of these patients and perhaps need to help them out with their rehabilitation. Finally, new protocols may be necessary for young metal-on-metal patients who desire a quicker return to activity,” he said.
Marker and colleagues followed 152 patients who underwent total hip resurfacing for a mean of 52 months. A single surgeon performed all of the procedures using the same prosthesis. To control for the learning curve associated with hip resurfacing, the studied cases consisted of operations performed after the surgeon’s first 100 resurfacing cases.
The investigators surveyed the patients preoperatively regarding their level of commitment to rehabilitation. The patients were asked to rate their commitment using a numbered scale representing outcomes ranging from no effort and poor compliance to high effort and 100% compliance.
The investigators also assessed the patients’ function using the Harris Hip Score (HSS) preoperatively and at final follow-up and evaluated patient satisfaction and SF-12 mental component (MCS) and physical component (PCS) scores postoperatively.
The investigators discovered a significant and positive correlation between patients’ commitment to rehabilitation and all of the studied outcome measures, including HHS, MCS, PCS and satisfaction. They also identified a negative correlation between body mass index and commitment to rehabilitation.
“Other factors such as age, gender and comorbidities had no influence in this model,” Marker said.
The study also showed that some patients discontinued with rehabilitation, but continued to have excellent outcomes. Further analysis revealed that these patients were already satisfied with their outcomes, suggesting that a more aggressive rehab protocol may be needed for these kinds of patients, he added.
Reference:
- Marker DR, Seyler TM, Bhave A, et al. Does commitment to rehabilitation influence clinical outcome of total hip resurfacing arthroplasty? Paper #545. Presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting. Feb. 25-28, 2009. Las Vegas.