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Clinical Orthopaedics and Related Research®

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01-11-2012 | Clinical Research

Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?

Authors: James A. Keeney, MD, Bradley S. Ellison, MD, William J. Maloney, MD, John C. Clohisy, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2012

Abstract

Background

Routine followup of patients after primary or revision THA is commonly practiced and driven by concerns that delays in identifying early failure will result in more complicated or more costly surgical interventions. Although mid-term followup (4–10 years) has been performed to follow cohorts of patients, the benefit of observing individual patients regardless of symptoms has not been established.

Questions/purposes

We determined (1) the reasons patients with THA return for mid-term followup, (2) the treatment recommendations and interventions occurring as a result of mid-term followup, and (3) how frequently revision surgery is recommended for asymptomatic and symptomatic patients at mid-term followup.

Methods

We retrospectively identified 501 patients (503 hips) who returned for followup at least 4 years (mean, 5 years; range, 4–10.9 years) after their primary or revision THA. We recorded their reasons for followup and treatment recommendations, including those for revision surgery, at mid-term followup.

Results

Fifty-three percent of patients returning for routine followup had no symptoms, 31% reported an unrelated musculoskeletal concern, and 19% had symptoms from their primary THA (15%) or revision THA (32%). Sixty-nine percent of symptomatic patients and 10% of asymptomatic patients received treatment recommendations, with physical therapy as the most frequent intervention (74%). Revision surgery was recommended for 6% of symptomatic and 0.6% of asymptomatic patients.

Conclusions

Although routine surveillance may identify rare, asymptomatic patients with arthroplasty failure, it is much more likely to result in recommendations for nonoperative management during early followup.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?
Authors: James A. Keeney, MD
Bradley S. Ellison, MD
William J. Maloney, MD
John C. Clohisy, MD
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2411-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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