A Matched Comparison of the Rates of Achieving the Minimal Clinically Important Difference Following Conversion and Primary Total Hip Arthroplasty |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts;2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;1. OrthoCarolina Hip and Knee Center, Atrium Musculoskeletal Institute, Charlotte, North Carolina;2. Covenant Physician Partners, Nashville, Tennessee;3. Department of Orthopedic Surgery, Stanford University School of Medicine, Palo Alto, California;1. Orthopaedic + Fracture Specialists, Portland, Oregon;2. Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri;3. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts;4. Connecticut Orthopaedics, Hamden, Connecticut;5. Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana;6. Department of Orthopaedic Surgery, Mid-Atlantic Permanente Medical Group, Washington, District of Columbia;7. Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, Mississippi;2. Department of Orthopaedics, University of Missouri, Columbia, Missouri;3. Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas;1. Campbell Clinic Department of Orthopaedic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee;2. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee;3. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina;4. Department of Physical Therapy, University of St. Augustine for Health Sciences, Austin, Texas;1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;2. Department of Orthopaedic Surgery, Boston University Medical Center, Boston, Massachusetts;3. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina |
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| Abstract: | BackgroundPatient-reported outcome measures (PROMs) are often lower following conversion total hip arthroplasty (cTHA) compared to matched primary total hip arthroplasty (THA) controls. However, the minimal clinically important differences (MCIDs) for any PROMs are yet to be analyzed for cTHA. This study aimed to (1) determine if patients undergoing cTHA achieve primary THA-specific 1-year PROM MCIDs at comparable rates to matched controls undergoing primary THA and (2) establish 1-year MCID values for specific PROMs following cTHA.MethodsA retrospective case-control study was conducted using 148 cases of cTHA which were matched 1:2 to 296 primary THA patients. Previously defined anchor values for 2 PROM measures in primary THA were used to compare cTHA to primary THA, while novel cTHA-specific MCID values for 2 PROMs were calculated through a distribution method. Predictors of achieving the MCID of PROMs were analyzed through multivariate logistic regressions.ResultsConversion THA was associated with decreased odds of achieving the primary THA-specific 1-year Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement PROM (Odds Ratio: 0.319, 95% Confidence Interval: 0.182-0.560, P < .001) and Patient Reported Outcomes Measurement Information System Physical Function Short-Form-10a PROM (Odds Ratio: 0.531, 95% Confidence Interval: 0.313-0.900, P = .019) MCIDs in reference to matched primary THA patients. Less than 60% of cTHA patients achieved an MCID. The 1-year MCID of the Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement and Patient Reported Outcomes Measurement Information System Physical Function Short-Form-10a specific to cTHA were +10.71 and +4.68, respectively.ConclusionWhile cTHA is within the same diagnosis-related group as primary THA, patients undergoing cTHA have decreased odds of achieving 1-year MCIDs of primary THA-specific PROMs.Level of EvidenceLevel III, retrospective comparative study. |
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| Keywords: | total hip arthroplasty conversion PROMs MCID cTHA |
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