The Journal of the American Academy of Orthopaedic Surgeons · 2025
Patient-Reported Outcome Measures After Direct Anterior Total Hip Arthroplasty Are Comparable Between Patients With Developmental Dysplasia of the Hip and Osteoarthritis: A Propensity-Matched Analysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Clark Sean C, Wright Breydan H, Feroe Aliya G, Couch Cory G, Taunton Michael J, Hevesi Mario
Аннотация
BACKGROUND: Degenerative changes secondary to hip dysplasia may be treated with total hip arthroplasty (THA) through a direct anterior approach. However, this may be challenging due to altered pathoanatomy and difficult visualization of the femur. The purpose of this study was to compare patient-reported outcome measures between patients with hip dysplasia and matched controls with osteoarthritis who underwent direct anterior THA.
METHODS: Patients who underwent direct anterior THA were retrospectively reviewed. Dysplastic hips were propensity matched to hips with osteoarthritis on a 1:4 basis. Patient-reported outcome measures, including visual analog scale pain at rest and with use, Hip Disability and Osteoarthritis Outcome Score Pain, and Forgotten Joint Score-12, were obtained at follow-up. In addition, modified Harris Hip scores (mHHS) were obtained both preoperatively and at the final follow-up.
RESULTS: Thirty-eight hips with dysplasia and 152 control hips were followed for a mean of 5.1 ± 2.8 years. Eighty-seven percent of the dysplastic hips had Grade I hip dysplasia based on the Crowe classification, whereas 5.3% had Grade II, 2.6% had Grade III, and 5.3% had Grade IV. Both cohorts demonstrated notable preoperative to postoperative improvements in mHHS ( P < 0.001). No differences were observed at the final follow-up between the dysplasia and osteoarthritis cohorts for VAS at rest (0.5 vs. 0.5, P = 0.828), visual analog scale with use (0.7 vs. 1.1, P = 0.231), Hip Disability and Osteoarthritis Outcome Score Pain (93.8 vs. 92.3, P = 0.518), Forgotten Joint Score-12 (82.2 vs. 81.4, P = 0.856), and mHHS (91.9 vs. 91.4, P = 0.793). Revision rates were comparable between the dysplasia and osteoarthritis cohorts (5.3% vs. 1.3%, P = 0.179).
CONCLUSION: Patients with hip dysplasia and osteoarthritis who underwent direct anterior THA achieved comparable outcomes in this propensity-matched analysis. Patients with hip dysplasia can expect reduced pain, improved functional outcomes, and similar revision surgery rates to those with osteoarthritis following primary THA.
METHODS: Patients who underwent direct anterior THA were retrospectively reviewed. Dysplastic hips were propensity matched to hips with osteoarthritis on a 1:4 basis. Patient-reported outcome measures, including visual analog scale pain at rest and with use, Hip Disability and Osteoarthritis Outcome Score Pain, and Forgotten Joint Score-12, were obtained at follow-up. In addition, modified Harris Hip scores (mHHS) were obtained both preoperatively and at the final follow-up.
RESULTS: Thirty-eight hips with dysplasia and 152 control hips were followed for a mean of 5.1 ± 2.8 years. Eighty-seven percent of the dysplastic hips had Grade I hip dysplasia based on the Crowe classification, whereas 5.3% had Grade II, 2.6% had Grade III, and 5.3% had Grade IV. Both cohorts demonstrated notable preoperative to postoperative improvements in mHHS ( P < 0.001). No differences were observed at the final follow-up between the dysplasia and osteoarthritis cohorts for VAS at rest (0.5 vs. 0.5, P = 0.828), visual analog scale with use (0.7 vs. 1.1, P = 0.231), Hip Disability and Osteoarthritis Outcome Score Pain (93.8 vs. 92.3, P = 0.518), Forgotten Joint Score-12 (82.2 vs. 81.4, P = 0.856), and mHHS (91.9 vs. 91.4, P = 0.793). Revision rates were comparable between the dysplasia and osteoarthritis cohorts (5.3% vs. 1.3%, P = 0.179).
CONCLUSION: Patients with hip dysplasia and osteoarthritis who underwent direct anterior THA achieved comparable outcomes in this propensity-matched analysis. Patients with hip dysplasia can expect reduced pain, improved functional outcomes, and similar revision surgery rates to those with osteoarthritis following primary THA.