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Preoperative status, socioeconomic factors affect clinical outcomes following cementless THA
Butler RA. Clin Orthop Relat Res. Published online: Aug. 18, 2010.
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A patient’s preoperative status and socioeconomic factors influenced the clinical outcome more than implant-related factors, according to this prospective, randomized trial.
Allen Butler, MD, and colleagues at Starkville Orthopedic Clinic, Starkville, Miss., offered all patients at their clinic enrollment in a prospective, randomized study in which they would receive either a titanium, proximally coated stem or a CoCr, cylindrical, extensively coated stem.
Preoperatively, the researchers collected patient data: diagnosis, age, gender, insurance status, medical comorbidities, tobacco and alcohol use, household income, educational level and history of treatment for lumbar pathology. The clinical evaluation included the Harris Hip Score, the SF-12, WOMAC, pain drawing, and UCLA activity rating and satisfaction questionnaire. Stem type, size, fit in the canal and stem-bone stiffness were the implant factors in this trial. The researchers observed 95% of the enrolled patients for 2 years.
The results showed that patient demographics and preoperative status were the best predictors of thigh pain, dissatisfaction and a low hip score. Ethnicity, educational poverty level, income and a low preoperative WOMAC score or preoperative SF-12 mental component score were the most predictive factors, the authors wrote. No implant parameters were linked to outcome or satisfaction.