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Revision total hip arthroplasty is associated with poorer clinically meaningful improvements and patient satisfaction compared to primary total hip arthroplasty.与初次全髋关节置换术相比，翻修全髋关节置换术在临床上有意义的改善和患者满意度方面较差。
J Orthop. 2021 Nov 27;28:96-100. doi: 10.1016/j.jor.2021.11.008. eCollection 2021 Nov-Dec.
2
Patient-Reported Outcomes Following Revision Total Hip Arthroplasty Demonstrate Less Improvement and Significantly Higher Rates of Worsening Compared to Primaries.与初次全髋关节置换术相比，翻修全髋关节置换术后患者报告的结局显示改善较少且恶化率显著更高。
J Arthroplasty. 2023 Nov;38(11):2410-2414. doi: 10.1016/j.arth.2023.05.053. Epub 2023 Jun 2.
3
Are Oxford Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index Useful Predictors of Clinical Meaningful Improvement and Satisfaction After Total Hip Arthroplasty?牛津髋关节评分和西部安大略省和麦克马斯特大学骨关节炎指数是否可作为全髋关节置换术后临床有意义改善和满意度的有用预测指标？
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Differences in Patient-Reported Outcome Measures Between Primary and Revision Total Hip Arthroplasty: Realistic Patient Expectations for Patients With Low Baseline Activity.原发性与翻修全髋关节置换术后患者报告结局测量的差异：低基线活动患者的现实患者期望。
Orthopedics. 2022 Jul-Aug;45(4):251-255. doi: 10.3928/01477447-20220225-04. Epub 2022 Mar 4.
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Preoperative mental distress is associated with poorer physical improvements after revision total hip arthroplasty.翻修全髋关节置换术后，术前精神困扰与较差的身体恢复相关。
J Orthop. 2022 Oct 21;35:18-23. doi: 10.1016/j.jor.2022.10.007. eCollection 2023 Jan.
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Does obesity lead to lower rates of clinically meaningful improvement or satisfaction after total hip arthroplasty? A propensity score-matched study.肥胖是否会导致全髋关节置换术后临床有意义的改善或满意度降低？一项倾向评分匹配研究。
Hip Int. 2022 Sep;32(5):610-619. doi: 10.1177/1120700020974656. Epub 2020 Nov 23.
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Machine learning algorithms do not outperform preoperative thresholds in predicting clinically meaningful improvements after total knee arthroplasty.机器学习算法在预测全膝关节置换术后具有临床意义的改善方面并不优于术前阈值。
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Does the Primary Surgical Approach Matter When Choosing the Approach for Revision Total Hip Arthroplasty?初次手术入路是否会影响翻修全髋关节置换术的入路选择？
J Arthroplasty. 2024 Jan;39(1):211-217. doi: 10.1016/j.arth.2023.06.040. Epub 2023 Jul 1.
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Conversion of hip resurfacing to total hip arthroplasty: is the outcome closer to primary or revision total hip arthroplasty?髋关节表面置换术转换为全髋关节置换术：其结果更接近初次全髋关节置换术还是翻修全髋关节置换术？
Orthop Traumatol Surg Res. 2024 Dec;110(8):103950. doi: 10.1016/j.otsr.2024.103950. Epub 2024 Jul 17.
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Minimum 5-Year Outcomes of Robotic-assisted Primary Total Hip Arthroplasty With a Nested Comparison Against Manual Primary Total Hip Arthroplasty: A Propensity Score-Matched Study.机器人辅助初次全髋关节置换术与传统初次全髋关节置换术的 5 年随访结果比较：一项倾向评分匹配研究。
J Am Acad Orthop Surg. 2020 Oct 15;28(20):847-856. doi: 10.5435/JAAOS-D-19-00328.

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Highly porous 3-D printed tritanium acetabular shell for aseptic revision total hip : Arthroplasty: minimum 2-year prospective follow up of 101 implants.用于无菌翻修全髋关节置换术的高孔隙率三维打印三钛髋臼杯：101例植入物至少2年的前瞻性随访
Arch Orthop Trauma Surg. 2025 Aug 19;145(1):411. doi: 10.1007/s00402-025-06034-0.
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Socioeconomic area deprivation index is not associated with postoperative complications following revision total hip and knee joint arthroplasty.社会经济区域贫困指数与翻修全髋关节和膝关节置换术后的并发症无关。
J Orthop. 2024 Jul 17;58:135-139. doi: 10.1016/j.jor.2024.07.008. eCollection 2024 Dec.
3
Propensity score-matched comparison of physical activity and quality of life between revision total hip arthroplasty and primary total hip arthroplasty.翻修全髋关节置换术与初次全髋关节置换术之间身体活动及生活质量的倾向评分匹配比较
J Orthop. 2023 Apr 18;40:23-28. doi: 10.1016/j.jor.2023.04.012. eCollection 2023 Jun.
4
Monobloc press-fit cups with large-diameter bearings are safe in revision total hip arthroplasty.采用大直径轴承的一体式压配髋臼杯用于髋关节翻修置换术是安全的。
Orthop Rev (Pavia). 2022 Nov 3;14(4):38926. doi: 10.52965/001c.38926. eCollection 2022.
5
Preoperative mental distress is associated with poorer physical improvements after revision total hip arthroplasty.翻修全髋关节置换术后，术前精神困扰与较差的身体恢复相关。
J Orthop. 2022 Oct 21;35:18-23. doi: 10.1016/j.jor.2022.10.007. eCollection 2023 Jan.

本文引用的文献

1
The influence of expectation modification in knee arthroplasty on satisfaction of patients: a randomized controlled trial.期待修改对膝关节置换术患者满意度的影响：一项随机对照试验。
Bone Joint J. 2021 Apr;103-B(4):619-626. doi: 10.1302/0301-620X.103B4.BJJ-2020-0629.R3.
2
Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action.精神健康状况在感染性翻修全膝关节置换术中更为普遍：采取行动的呼吁。
J Knee Surg. 2022 Jan;35(2):190-197. doi: 10.1055/s-0040-1713756. Epub 2020 Jul 13.
3
Are Oxford Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index Useful Predictors of Clinical Meaningful Improvement and Satisfaction After Total Hip Arthroplasty?牛津髋关节评分和西部安大略省和麦克马斯特大学骨关节炎指数是否可作为全髋关节置换术后临床有意义改善和满意度的有用预测指标？
J Arthroplasty. 2020 Sep;35(9):2458-2464. doi: 10.1016/j.arth.2020.04.034. Epub 2020 Apr 20.
4
Osteoarthritis in the Middle-Aged and Elderly in China: Prevalence and Influencing Factors.中国中老年人群骨关节炎：患病率及影响因素。
Int J Environ Res Public Health. 2019 Nov 26;16(23):4701. doi: 10.3390/ijerph16234701.
5
Changes in Patient Satisfaction Following Total Joint Arthroplasty.关节置换术后患者满意度的变化。
J Arthroplasty. 2020 Jan;35(1):32-38. doi: 10.1016/j.arth.2019.08.018. Epub 2019 Aug 10.
6
What Preoperative Factors are Associated With Not Achieving a Minimum Clinically Important Difference After THA? Findings from an International Multicenter Study.哪些术前因素与 THA 后未达到最小临床重要差异有关？一项国际多中心研究的结果。
Clin Orthop Relat Res. 2019 Jun;477(6):1301-1312. doi: 10.1097/CORR.0000000000000667.
7
A systematic review of the causes of failure of Revision Total Hip Arthroplasty.全髋关节翻修术失败原因的系统评价
J Orthop. 2019 May 2;16(5):393-395. doi: 10.1016/j.jor.2019.04.011. eCollection 2019 Sep-Oct.
8
Comparison of the incidences and risk factors for pulmonary complications after primary and revision total hip arthroplasty.初次全髋关节置换术与翻修全髋关节置换术后肺部并发症的发生率及危险因素比较。
Korean J Anesthesiol. 2009 Jul;57(1):50-55. doi: 10.4097/kjae.2009.57.1.50.
9
Current Trends in Patient-Reported Outcome Measures in Total Joint Arthroplasty: A Study of 4 Major Orthopaedic Journals.当前全膝关节置换术患者报告结局测量的趋势：四大骨科期刊研究。
J Arthroplasty. 2018 Nov;33(11):3416-3421. doi: 10.1016/j.arth.2018.06.034. Epub 2018 Jul 3.
10
Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature.使用WOMAC评分预测全膝关节置换术的结果：文献综述
J Knee Surg. 2019 Aug;32(8):736-741. doi: 10.1055/s-0038-1666866. Epub 2018 Jul 10.

与初次全髋关节置换术相比，翻修全髋关节置换术在临床上有意义的改善和患者满意度方面较差。

Revision total hip arthroplasty is associated with poorer clinically meaningful improvements and patient satisfaction compared to primary total hip arthroplasty.

作者信息

Zhang Siyuan, Chen Jerry Yongqiang, Pang Hee Nee, Lo Ngai Nung, Yeo Seng Jin, Liow Ming Han Lincoln

机构信息

Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.

出版信息

J Orthop. 2021 Nov 27;28:96-100. doi: 10.1016/j.jor.2021.11.008. eCollection 2021 Nov-Dec.

DOI:10.1016/j.jor.2021.11.008
PMID:34898927
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8636994/
Abstract

PURPOSE

This study aims to compare PROM improvements and satisfaction rates between revision (rTHA) and primary total hip arthroplasty (pTHA).

METHODS

84 rTHAs were propensity-score matched to 168 pTHAs using patient demographics and preoperative PROMs. Multiple regression was used to evaluate differences in PROMs, minimal clinically important difference (MCID) attainment and patient satisfaction.

RESULTS

Compared to pTHA patients, rTHA patients had poorer MCID attainment for OHS, WOMAC and SF-36 PCS and lower satisfaction rates at 2-years postoperatively (p < 0.05).

CONCLUSION

Patients undergoing rTHA are likely to have poorer outcomes and should be appropriately counselled to better manage their preoperative expectations.

LEVEL OF EVIDENCE

Level II.

摘要

目的

本研究旨在比较翻修全髋关节置换术（rTHA）和初次全髋关节置换术（pTHA）患者术后患者报告结局量表（PROM）的改善情况及满意度。

方法

采用患者人口统计学资料和术前PROM，将84例rTHA患者与168例pTHA患者进行倾向评分匹配。采用多元回归分析评估PROM、最小临床重要差异（MCID）达成情况及患者满意度的差异。

结果

与pTHA患者相比，rTHA患者在术后2年时，髋关节功能评分（OHS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）及简明健康状况调查量表（SF-36）生理健康分量表（PCS）的MCID达成情况较差，满意度较低（p<0.05）。

结论

接受rTHA的患者可能预后较差，应给予适当的咨询，以更好地管理其术前预期。

证据等级

二级。