Orthopedics. 2022 Jul-Aug;45(4):251-255. doi: 10.3928/01477447-20220225-04. Epub 2022 Mar 4.
Primary total hip arthroplasty (pTHA) and revision total hip arthroplasty (rTHA) are not often compared in terms of patient-reported outcome measures (PROMs). However, surgeons and patients need to better understand the differences in PROMs between primary and revision surgery to set realistic patient expectations and recovery milestones. A matched cohort study of pTHA to rTHA was performed with our arthroplasty database of a single surgeon's experience from 2012 to 2018. There was a significant difference in both pre-operative assessment and change from preoperative to postoperative assessment of the PROMs. Patients undergoing pTHA had higher visual analog scale (VAS) pain scores (67.9 vs 57.9, =.004). Those undergoing rTHA had higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (57.1 vs 50.1, =.008) and Veterans RAND 12 Item Health Survey (VR-12) (33.5 vs 33.1, =.01) scores. However, a significant change was noted in the difference from preoperative to postoperative scores between the pTHA and rTHA groups: Harris Hip Score (HHS) total score (pTHA 30.7 vs rTHA 4.4, <.001), WOMAC score (pTHA 29.3 vs rTHA 12.2, <.001), and VAS pain score (pTHA -48.3 vs rTHA -26.5, <.001) as well as groin pain (pTHA 1.4% vs rTHA 7.1%, =.02). Further, PROMs after rTHA were inferior to those after pTHA with several outcome instruments, including HHS, WOMAC score, and VAS pain score. In addition, groin pain was significantly greater in the rTHA cohort compared with the pTHA cohort at the latest follow-up. This study allows surgeons and patients to better understand the differences in PROMs to set realistic patient expectations and recovery milestones. [. 2022;45(4):251-255.].
初次全髋关节置换术（pTHA）和翻修全髋关节置换术（rTHA）在患者报告的结果测量（PROMs）方面通常不进行比较。然而，为了设定现实的患者预期和康复里程碑，外科医生和患者需要更好地理解初次手术和翻修手术之间 PROMs 的差异。对 2012 年至 2018 年期间一位外科医生的关节置换数据库进行了 pTHA 与 rTHA 的配对队列研究。在 PROMs 的术前评估和从术前到术后评估的变化方面，均存在显著差异。接受 pTHA 的患者视觉模拟量表（VAS）疼痛评分较高（67.9 比 57.9，=.004）。接受 rTHA 的患者 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）评分较高（57.1 比 50.1，=.008）和退伍军人 RAND 12 项健康调查（VR-12）评分较高（33.5 比 33.1，=.01）。然而，在 pTHA 和 rTHA 组之间，从术前到术后评分的差异显著：Harris 髋关节评分（HHS）总分（pTHA 30.7 比 rTHA 4.4，<.001）、WOMAC 评分（pTHA 29.3 比 rTHA 12.2，<.001）和 VAS 疼痛评分（pTHA -48.3 比 rTHA -26.5，<.001）以及腹股沟疼痛（pTHA 1.4%比 rTHA 7.1%，=.02）。此外，rTHA 后的 PROMs 在几个结果工具方面均劣于 pTHA，包括 HHS、WOMAC 评分和 VAS 疼痛评分。此外，rTHA 队列在末次随访时的腹股沟疼痛明显大于 pTHA 队列。本研究使外科医生和患者能够更好地理解 PROMs 的差异，从而设定现实的患者预期和康复里程碑。[2022;45(4):251-255.]。
