Evaluation of the appropriateness of hip joint replacement techniques.
Int J Technol Assess Health Care
; 16(1): 165-77, 2000.
Article
en En
| MEDLINE
| ID: mdl-10815362
ABSTRACT
OBJECTIVE:
To evaluate the appropriateness of the use of hip joint replacements (HJRs) using explicit criteria developed by an expert panel.METHODS:
Observational study. Nine hundred ninety-seven patients from five hospitals with a diagnosis of osteoarthritis, avascular necrosis, hip fracture, or revision who were undergoing HJR were consecutively included in the study during a 1-year period. The appropriateness of the indication was judged by explicit criteria. Complications were recorded at the time of the intervention and 3 months postoperatively.RESULTS:
Of the 1,030 interventions, 604 were for osteoarthritis, 31 avascular necrosis, 191 fractures, and 204 revisions. No differences were found among the hospitals for the main clinical and patient variables. Indications for surgery were considered appropriate in 59% of cases, uncertain in 32%, and inappropriate in 8%, mainly in the osteoarthritis group. Differences were found in the rates of appropriateness among some centers. The complication rate did not differ among the groups based on the level of appropriateness of the procedure.CONCLUSIONS:
The appropriate use of HJR, as measured by the criteria established by the panel, identified a moderate percentage of inappropriate indications. Those equivocal and inappropriate cases demand further studies to identify patients with an adequate risk-to-benefit ratio from this procedure.
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Bases de datos:
MEDLINE
Asunto principal:
Guías de Práctica Clínica como Asunto
/
Artroplastia de Reemplazo de Cadera
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Int J Technol Assess Health Care
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2000
Tipo del documento:
Article