Fujita Kimie, Makimoto Kiyoko, Tabuchi Yasuko, Matsunaga-Myoji Yuriko, Mawatari Masaaki
Department of Health Sciences, Kyushu University, Fukuoka, Japan.
Department of Health Sciences, Osaka University, Osaka, Japan.
J Arthroplasty. 2023 Dec;38(12):2673-2679. doi: 10.1016/j.arth.2023.06.016. Epub 2023 Jun 13.
Available evidence on outcomes at 5 years and beyond for total hip arthroplasty (THA) is mainly limited to patient-reported outcome measures (PROMs). This study documented the trajectory of functional measurement using the Oxford hip score (OHS) and floor-sitting posture in Japan for up to 10 years post-THA and investigated predictors of dissatisfaction at 10 years with THA.
Patients scheduled for primary THA at a university hospital in Japan between 2003 and 2006 were enrolled in this prospective study. Overall, 826 preoperative participants were eligible for follow-up, with response rates ranging from 93.6% to 69.4% at each postoperative survey point. The OHS and floor-sitting scores were calculated using a self-administered questionnaire 6 times up to 10 years postoperatively. Patient satisfaction, including general surgery, walking ability, and activities of daily living (ADL), was assessed in the 10-year survey.
The linear mixed-effects model demonstrated a postoperative improvement, peaking at 7 years for OHS and 5 years earlier for the floor-sitting score. The postoperative overall surgical dissatisfaction at 10 years with THA was very low (3.2%). No predictors of surgical dissatisfaction were identified in the logistic regression analyses. Predictors of walking ability dissatisfaction were older age, men, and worse OHS at 1 year postoperatively. Predictors of ADL dissatisfaction were poorer preoperative and 1-year postoperative floor-sitting scores and 1-year postoperative OHS.
The floor-sitting score is a simple PROM suitable for the Japanese population; other populations would require a scale suitable for their lifestyles.
全髋关节置换术(THA)5年及更长期的现有结局证据主要限于患者报告的结局指标(PROMs)。本研究记录了日本THA术后长达10年使用牛津髋关节评分(OHS)和从坐到站姿势的功能测量轨迹,并调查了THA术后10年不满意的预测因素。
纳入2003年至2006年期间在日本一家大学医院计划进行初次THA的患者进行这项前瞻性研究。总体而言,826名术前参与者符合随访条件,各术后调查点的应答率在93.6%至69.4%之间。术后长达10年使用自填式问卷计算OHS和从坐到站评分6次。在10年的调查中评估患者满意度,包括一般手术、步行能力和日常生活活动(ADL)。
线性混合效应模型显示术后有所改善,OHS在7年时达到峰值,从坐到站评分则提前5年达到峰值。THA术后10年的总体手术不满意率非常低(3.2%)。在逻辑回归分析中未发现手术不满意的预测因素。步行能力不满意的预测因素是年龄较大、男性以及术后1年OHS较差。ADL不满意的预测因素是术前和术后1年从坐到站评分较差以及术后1年OHS较差。
从坐到站评分是一种适用于日本人群的简单PROM;其他人群则需要适合其生活方式的量表。