1.Patient-reported Outcome Measures of Revision Total Hip Arthroplasty for Prosthetic Joint Infection is not Inferior to Aseptic Revision Total Hip Arthroplasty
Lim JBT ; Pang HN ; Tay KJD ; Chia SL ; Yeo SJ ; Lo NN
Malaysian Orthopaedic Journal 2020;14(No.3):73-81
Introduction: This study aims to investigate whether
patients undergoing two-stage revision total hip arthroplasty
(THA) for prosthetic joint infection (PJI) and one-stage
revision THA for aseptic reasons have similar clinical
outcomes and patient satisfaction during their post-operative
follow-up. We hypothesise that the two-stage revision THA
for PJI is associated with poorer outcomes as compared to
aseptic revision THA.
Materials and Methods: We reviewed prospectively
collected data in our tertiary hospital arthroplasty registry
and identified patients who underwent revision THA
between 2001 and 2014, with a minimum of two years
follow-up. The study group (two-stage revision THA for PJI)
consists of 23 patients and the control group (one-stage
revision THA for aseptic reasons) consists of 231 patients.
Patient demographics, Western Ontario and McMaster
Universities Arthritis Index (WOMAC), Oxford Hip Score
(OHS), Short Form-36 (SF-36) scores and patient reported
satisfaction were evaluated. Student’s t-test was used to
compare continuous variables between the two groups.
Statistical significance was defined as p <0.05.
Results: The pre-operative demographics and clinical scores
were relatively similar between the two groups of patients.
At two years, patients who underwent revision THA for PJI
reported a better WOMAC Pain Score and OHS as compared
to aseptic revision THA. A similar proportion of patients
were satisfied with their results of surgery in both groups
(p=0.093).
Conclusions: Although patients who underwent revision
THA for PJI had poorer pre-operative functional scores
(WOMAC function and SF-36 PF), at two years follow-up,
these two groups of patients have comparable post-operative
outcomes. Interestingly, patients who had revision THA for
PJI reported a better clinical outcome in terms of OHS and
WOMAC Pain score as compared to the aseptic group. We
conclude that the revision THA for PJI is not inferior to
aseptic revision THA in terms of patient satisfaction and
clinical outcomes.