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National Joint Registry defends THR as procedure that improves patient function
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In response to an article published in The Sun about unilateral total hip replacement failing to improve patient function, Martyn Porter, FRCS, medical director of the National Joint Replacement Registry, or NJR, for England, Wales, Northern Ireland and the Isle of Man, said in a NJR press release, “The main reason for doing hip replacement is to improve pain and there is overwhelming evidence that hip replacement is a wonderful success at improving pain dramatically for the vast majority of patients. The second reason for doing hip replacement is to improve function.”
The Sun article based its conclusions on a meta-analysis by Thomas M. Withers and colleagues, of Norwich, United Kingdom and noted the U.K. National Health System has “wasted” its money covering total hip replacement (THR) because THR fails to improve patients’ function and make them more active.
Porter said in the release, “There is overwhelming evidence that patients report marked improvement in function after joint replacement.”
The Sun article cited the review article published in Clinical Rehabilitation in which the authors concluded, “There is no statistically significant difference in physical activity levels before and up to 1 year after unilateral primary total hip replacement. However, the low to moderate methodological quality of the included articles should be taken into consideration when drawing conclusions.”
Porter said in the release that most THR tests done in the first postoperative year do not show a marked improvement in some activity measures but, during that time, patients may report excellent hip function during activities “because it no longer hurts.”
The Withers study analyzed 17 citations of published studies for which the quality of evidence was low to moderate and showed no statistically significant difference between pre- and post-THR assessments for four activity-based measures.
Orthopaedic surgeon Ashley Blom, MBChB, MD, PhD, FRCS, FRCS (Tr & Ortho), the head of statistical analysis for the NJR, said in the release, “Any suggestion that hip replacement does not work in the overwhelming majority of patients or is a waste of money is incredibly misleading and misrepresents the fine work done by Thomas Withers and team.”
References:
Withers TM, et al. Clin Rehabil. 2016;doi: 10.1177/0269215516673884.