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Total Hip Arthroplasty Versus Education and Exercise: A Propensity-Matched Analysis of 266 Patients Who Have Hip Osteoarthritis.
Young, James J; Zywiel, Michael G; Skou, Søren T; Chandran, Vinod; Davey, J Rod; Gandhi, Rajiv; Mahomed, Nizar N; Syed, Khalid; Veillette, Christian J H; Rampersaud, Y Raja; Perruccio, Anthony V.
  • Young JJ; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Department of Sports Science and Clinical Biomechanics, Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark.
  • Zywiel MG; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Department of Surgery, University of
  • Skou ST; Department of Sports Science and Clinical Biomechanics, Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark; The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.
  • Chandran V; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and
  • Davey JR; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Gandhi R; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Mahomed NN; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Department of Surgery, University of
  • Syed K; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada.
  • Veillette CJH; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Rampersaud YR; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Perruccio AV; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Department of Surgery, University of
J Arthroplasty ; 2024 Apr 30.
Article en En | MEDLINE | ID: mdl-38697319
ABSTRACT

BACKGROUND:

Total hip arthroplasty (THA) for osteoarthritis (OA) is a major health system cost. Education and exercise (Edu + Ex) programs may reduce the number of THAs needed, but supporting data are limited. This study aimed to estimate the treatment effect of THA versus Edu + Ex on pain, function, and quality of life outcomes 3 and 12 months after treatment initiation for hip OA.

METHODS:

Patients who had hip OA who underwent THA or an Edu + Ex program were included in this propensity-matched study. In 778 patients (Edu + Ex, n = 303; THA, n = 475), propensity scores were based on pretreatment characteristics, and patients were matched on a 11 ratio. Between-group treatment effects (pain, function, and quality of life) were estimated as the mean difference (MD) in change from pretreatment to 3-month and 12-month follow-up using linear mixed models.

RESULTS:

The matched sample consisted of 266 patients (Edu + Ex, n = 133; THA, n = 133) who were balanced on all pretreatment characteristics except opioid use. At 12-month follow-up, THA resulted in significantly greater improvements in pain (MD 35.4; 95% confidence interval [CI] 31.4 to 39.4), function (MD 30.5; 95% CI 26.3 to 34.7), and quality of life (MD 33.6; 95% CI 28.8 to 38.4). Between 17% and 30% of patients receiving Edu + Ex experienced a surgical threshold for clinically meaningful improvement in outcomes, compared to 84% and 90% of THA patients.

CONCLUSIONS:

A THA provides greater improvements in pain, function, and quality of life. A notable proportion of Edu + Ex patients had clinically meaningful improvements, suggesting Edu + Ex may result in THA deferral in some patients, but confirmatory trials are needed.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Año: 2024 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Search on Google

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Año: 2024 Tipo del documento: Article