What Preoperative Factors are Associated With Not Achieving a Minimum Clinically Important Difference After THA? Findings from an International Multicenter Study.

CONCLUSIONS: These findings suggest that surgeons should counsel patients with high joint space width, female patients, and patients undergoing surgery in Scandinavia that they may be much less likely to experience meaningful pain relief or functional improvement after THA, and in light of that, determine whether indeed surgery should be postponed or avoided in those patients. Lower SF-36 MCS score and higher HHS before surgery were also found to be associated with not achieving MCIDs in pain and physical function, respectively, after surgery, but both had relatively small effect sizes. Future prospective studies may consider exploring the relationship between less pain relief or functional improvement and the risk factors identified in this study, such as high joint space width, to validate our findings and determine if the variables we identified are truly predictive of worse postoperative outcomes. Future retrospective studies of regional or national registry data should use the analysis methods presented within this study to both identify the portion of the THA patients who do not achieve a MCID in pain or physical function after surgery and confirm if the preoperative risk factors for poor improvement identified within our international, multicenter cohort are also found in a larger patient population with more diverse implants and comorbidities. LEVEL OF EVIDENCE: Level III, therapeutic study. PMID: 31136425 [PubMed - in process]
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research