Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition

HSS Journal Online First Article

Michael P. Ast, MD
Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery

Alexandra H. Gorab, BS
Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery

Natalie Parkes, BA
Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery

John Boles, BS
Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery

Yuo-yu Lee, MS
Hospital for Special Surgery

Geoffrey H. Westrich, MD
Geoffrey H. Westrich, MD

Attending Orthopedic Surgeon, Hospital for Special Surgery
Research Director of Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery

Stephen Lyman, PhD
Stephen Lyman, PhD
Director, Healthcare Research Institute, Hospital for Special Surgery
Associate Scientist, Hospital for Special Surgery
Associate Professor of Public Health, Department of Health Policy and Research, Weill Cornell Medical College

Abstract

Background
Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of life.

Questions/Purposes
We sought to determine if any difference in quality of life measures could be detected in patients treated with total hip replacement implanted with cobalt-chrome (CoCr) versus ceramic femoral heads at 2-year follow-up.

Methods
We compared the hip disability and osteoarthritis outcome score (HOOS) and EuroQOL (EQ5D) scores of a matched set of patients that underwent primary total hip arthroplasty with highly cross-linked polyethylene (HXLPE) and a single implant system consisting of either a metal or a ceramic femoral head.

Results
Clinical outcomes and quality of life improved for both groups after hip replacement surgery. Patients with a ceramic head showed greater improvement than those with a metal head in HOOS pain and EQ5D VAS scores by a statistically significant margin (p = 0.0417 and 0.019, respectively), but the differences between the HOOS and EQ5D VAS scores (3.4 and 0.04, respectively) do not demonstrate a clinically significant difference.

Conclusions
We found that the femoral head composition has no effect on clinical outcomes or patient quality of life at 2 years.

Level of Evidence: Therapeutic Study Level III

This Online First article was published online in March 2015.
View the full HSS Journal article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

 

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