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Patient-reported outcomes following primary total hip arthroplasty in Crowe type Ⅲ or Ⅳ developmental dysplasia are comparable to those in Crowe type Ⅰ: a case-control study of 96 hips with intermediate-term follow-up
Tamon Kabata
Kanazawa University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0183-4464
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Background: A few previous studies have investigated patient satisfaction after total hip arthroplasty (THA) according to the degree of pelvic deformity. This study compared patient-reported outcomes after primary THA for Crowe types Ⅲ, Ⅳ and I dysplasia.
Methods: This retrospective, single-center, single-surgeon case-control study included patients who underwent primary THA between 2008 and 2016. We sent postal questionnaires to 38 patients with Crowe type III and IV dysplasia. Among the questionnaire respondents, 23 patients, excluding those with a follow-up period of < 1 year, were enrolled as the H group. The control group included 46 patients with Crowe type I, matched for sex, age, body mass index and surgical approach. To investigate the influence of femoral shortening osteotomy, the H group was divided according to whether femoral shortening osteotomy was performed. Ten patients underwent THA with femoral shortening osteotomy (FO group), while 12 patients underwent THA without femoral shortening osteotomy (N-FO group). Patient demographics, mean follow-up period, surgical information, pre- and postoperative leg length discrepancy (LLD), and perioperative complications were investigated. Clinical evaluations were performed using the Japanese Orthopaedic Association (JOA) scores, 36-item short-form survey (SF-36), net promotor score (NPS), visual analogue scale (VAS), and questionnaires. The VAS and SF-36 scores were determined only at final follow-up.
Results: The H and control groups were not significantly different in the postoperative JOA scores and SF-36. In the H group, VAS at the final follow-up was significantly higher, and significantly more patients felt that postoperative rehabilitation was serious, expressing that they underwent THA for LLD correction. In addition, the VAS scores in the FO group was higher than those in the N-FO group. Postoperative LLD was significantly greater in the H group than in the control group. Each group had an NPS of >50.
Conclusion: The postoperative VAS score was higher in Crowe type Ⅲ and Ⅳ dysplasia than in Crowe type I dysplasia, but no significant differences were detected in the postoperative satisfaction, JOA score, and SF-36 score. These findings may help explain the effects of THA preoperatively to patients with Crowe type Ⅲ and Ⅳ dysplasia.
Level of Evidence: Therapeutic Level 3b
Keywords
total hip arthroplasty, Crowe classification, satisfaction, patient reported outcome, case control study
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On 11 May, 2020
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On 30 Apr, 2020
Review #3 received
Received 30 Apr, 2020
Reviewer #2 agreed
On 28 Apr, 2020
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Received 28 Apr, 2020
Reviewers invited
Invitations sent on 27 Apr, 2020
Reviewer #1 agreed
On 27 Apr, 2020
Review #1 received
Received 27 Apr, 2020
Editor assigned
On 23 Apr, 2020
Editor invited
On 22 Apr, 2020
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On 16 Apr, 2020
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Editorial decision: Major revision
On 31 Mar, 2020
Review #3 received
Received 20 Mar, 2020
Reviewer #3 agreed
On 10 Mar, 2020
Review #2 received
Received 06 Mar, 2020
Reviewer #2 agreed
On 04 Mar, 2020
Reviewer #1 agreed
On 08 Jan, 2020
Review #1 received
Received 08 Jan, 2020
Reviewers invited
Invitations sent on 02 Jan, 2020
Editor assigned
On 20 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
First submitted
On 04 Dec, 2019
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Subject Areas
Orthopedics
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Patient-reported outcomes following primary total hip arthroplasty in Crowe type Ⅲ or Ⅳ developmental dysplasia are comparable to those in Crowe type Ⅰ: a case-control study of 96 hips with intermediate-term follow-up
Tamon Kabata
Kanazawa University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0183-4464
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 21 May, 2020
No community comments so far
Editor assigned
On 11 May, 2020
Submission checks complete
On 10 May, 2020
Editor invited
On 10 May, 2020
No comments provided
Editorial decision: Minor revision
On 05 May, 2020
Reviewer #3 agreed
On 30 Apr, 2020
Review #3 received
Received 30 Apr, 2020
Reviewer #2 agreed
On 28 Apr, 2020
Review #2 received
Received 28 Apr, 2020
Reviewers invited
Invitations sent on 27 Apr, 2020
Reviewer #1 agreed
On 27 Apr, 2020
Review #1 received
Received 27 Apr, 2020
Editor assigned
On 23 Apr, 2020
Editor invited
On 22 Apr, 2020
Submission checks complete
On 16 Apr, 2020
No comments provided
Editorial decision: Major revision
On 31 Mar, 2020
Review #3 received
Received 20 Mar, 2020
Reviewer #3 agreed
On 10 Mar, 2020
Review #2 received
Received 06 Mar, 2020
Reviewer #2 agreed
On 04 Mar, 2020
Reviewer #1 agreed
On 08 Jan, 2020
Review #1 received
Received 08 Jan, 2020
Reviewers invited
Invitations sent on 02 Jan, 2020
Editor assigned
On 20 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
First submitted
On 04 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: A few previous studies have investigated patient satisfaction after total hip arthroplasty (THA) according to the degree of pelvic deformity. This study compared patient-reported outcomes after primary THA for Crowe types Ⅲ, Ⅳ and I dysplasia.
Methods: This retrospective, single-center, single-surgeon case-control study included patients who underwent primary THA between 2008 and 2016. We sent postal questionnaires to 38 patients with Crowe type III and IV dysplasia. Among the questionnaire respondents, 23 patients, excluding those with a follow-up period of < 1 year, were enrolled as the H group. The control group included 46 patients with Crowe type I, matched for sex, age, body mass index and surgical approach. To investigate the influence of femoral shortening osteotomy, the H group was divided according to whether femoral shortening osteotomy was performed. Ten patients underwent THA with femoral shortening osteotomy (FO group), while 12 patients underwent THA without femoral shortening osteotomy (N-FO group). Patient demographics, mean follow-up period, surgical information, pre- and postoperative leg length discrepancy (LLD), and perioperative complications were investigated. Clinical evaluations were performed using the Japanese Orthopaedic Association (JOA) scores, 36-item short-form survey (SF-36), net promotor score (NPS), visual analogue scale (VAS), and questionnaires. The VAS and SF-36 scores were determined only at final follow-up.
Results: The H and control groups were not significantly different in the postoperative JOA scores and SF-36. In the H group, VAS at the final follow-up was significantly higher, and significantly more patients felt that postoperative rehabilitation was serious, expressing that they underwent THA for LLD correction. In addition, the VAS scores in the FO group was higher than those in the N-FO group. Postoperative LLD was significantly greater in the H group than in the control group. Each group had an NPS of >50.
Conclusion: The postoperative VAS score was higher in Crowe type Ⅲ and Ⅳ dysplasia than in Crowe type I dysplasia, but no significant differences were detected in the postoperative satisfaction, JOA score, and SF-36 score. These findings may help explain the effects of THA preoperatively to patients with Crowe type Ⅲ and Ⅳ dysplasia.
Level of Evidence: Therapeutic Level 3b
Figure 1
Figure 2
Figure 3