Top

Quality of Life Research

Gepubliceerd in:

01-11-2009

Quality of life after dislocation of hip arthroplasty: a prospective cohort study on 319 patients with femoral neck fractures with a one-year follow-up

Auteurs: Anders Enocson, Hans Pettersson, Sari Ponzer, Hans Törnkvist, Nils Dalén, Jan Tidermark

Gepubliceerd in: Quality of Life Research | Uitgave 9/2009

Abstract

Purpose

A primary arthroplasty constitutes a standard procedure in the treatment of patients with displaced fractures of the femoral neck. Although dislocation of the prosthesis remains a significant clinical problem, there are no previous reports on its influence on health-related quality of life (HRQoL). We analysed how a dislocation of the hip arthroplasty influenced the patients’ HRQoL.

Methods

In total 319 consecutive patients with a displaced fracture of the femoral neck treated with a primary arthroplasty were included in a prospective cohort study. We used a mixed-effects model regression analysis to evaluate factors of importance for HRQoL (EQ-5D_index score) during the first 12 months following surgery.

Results

A dislocation of the arthroplasty occurred in 21 of the 319 patients (7%), 8 of whom had a single dislocation and 13 recurrent dislocations. At 4 months, the EQ-5D_index score displayed a significantly worse outcome for patients with recurrent dislocations compared to patients with no dislocation (P = 0.001), and a trend towards a worse outcome for patients with a single dislocation (P = 0.08). At 12 months, the mean EQ-5D_index score of patients with recurrent dislocations was still substantially lower (P = 0.001), while the EQ-5D_index score for patients with a single dislocation had returned to a level similar to that of patients with no dislocation. Our analysis of the EQ-5D dimensions indicates that the difference was mainly due to perceived difficulties in self-care and usual activities and increased problems with anxiety/depression.

Conclusions

A recurrent dislocation of the hip arthroplasty in the treatment of patients with femoral neck fractures seems to result in a persisting deterioration in the HRQoL, while patients with a single dislocation seem to experience only a temporary deterioration.

vorige artikel Gender-related traits, quality of life, and psychological adjustment among women with irritable bowel syndrome

volgende artikel Factors associated with health-related quality of life after successful kidney transplantation: a population-based study

Tidermark, J., Ponzer, S., Svensson, O., Söderqvist, A., & Törnkvist, H. (2003). Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. Journal of Bone and Joint Surgery. British Volume, 85(3), 380–388. doi:10.1302/0301-620X.85B3.13609.PubMedCrossRef

Keating, J. F., Grant, A., Masson, M., Scott, N. W., & Forbes, J. F. (2006). Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. Journal of Bone and Joint Surgery. American Volume, 88(2), 249–260. doi:10.2106/JBJS.E.00215.CrossRef

Frihagen, F., Grotle, M., Madsen, J. E., Wyller, T. B., Mowinckel, P., & Nordsletten, L. (2008). Outcome after femoral neck fractures: A comparison of Harris Hip Score, Eq-5d and Barthel Index. Injury, 39(10), 1147–1156. doi:10.1016/j.injury.2008.03.027.PubMedCrossRef

Blomfeldt, R., Törnkvist, H., Eriksson, K., Söderqvist, A., Ponzer, S., & Tidermark, J. (2007). A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. Journal of Bone and Joint Surgery. British Volume, 89(2), 160–165. doi:10.1302/0301-620X.89B2.18576.PubMedCrossRef

Meek, R. M., Allan, D. B., McPhillips, G., Kerr, L., & Howie, C. R. (2006). Epidemiology of dislocation after total hip arthroplasty. Clinical Orthopaedics and Related Research, 447, 9–18. doi:10.1097/01.blo.0000218754.12311.4a.PubMedCrossRef

Berry, D. J., von Knoch, M., Schleck, C. D., & Harmsen, W. S. (2004). The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 86(1), 9–14.

Woo, R. Y., & Morrey, B. F. (1982). Dislocations after total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 64(9), 1295–1306.

Pajarinen, J., Savolainen, V., Tulikoura, I., Lindahl, J., & Hirvensalo, E. (2003). Factors predisposing to dislocation of the Thompson hemiarthroplasty: 22 Dislocations in 338 patients. Acta Orthopaedica Scandinavica, 74(1), 45–48. doi:10.1080/00016470310013644.PubMedCrossRef

Varley, J., & Parker, M. J. (2004). Stability of hip hemiarthroplasties. International Orthopaedics, 28(5), 274–277. doi:10.1007/s00264-004-0572-z.PubMedCrossRef

10.

Enocson, A., Tidermark, J., Törnkvist, H., & Lapidus, L. J. (2008). Dislocation of hemiarthroplasty after femoral neck fracture: Better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthopaedica, 79(2), 211–217. doi:10.1080/17453670710014996.PubMedCrossRef

11.

Johansson, T., Jacobsson, S. A., Ivarsson, I., Knutsson, A., & Wahlström, O. (2000). Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: A prospective randomized study of 100 hips. Acta Orthopaedica Scandinavica, 71(6), 597–602. doi:10.1080/000164700317362235.PubMedCrossRef

12.

Lu-Yao, G. L., Keller, R. B., Littenberg, B., & Wennberg, J. E. (1994). Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. Journal of Bone and Joint Surgery. American Volume, 76(1), 15–25.

13.

Enocson, A., Hedbeck, C.-J., Tidermark, J., Pettersson, H., Ponzer, S., & Lapidus, L. J. (2009). Dislocation of total hip replacement in patients with fractures of the femoral neck. A prospective cohort study of 713 consecutive hips. Acta Orthopaedica, 80(2), 184–189. doi:10.3109/17453670902930024.PubMedCrossRef

14.

Sanchez-Sotelo, J., Haidukewych, G. J., & Boberg, C. J. (2006). Hospital cost of dislocation after primary total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 88(2), 290–294. doi:10.2106/JBJS.D.02799.CrossRef

15.

Blewitt, N., & Mortimore, S. (1992). Outcome of dislocation after hemiarthroplasty for fractured neck of the femur. Injury, 23(5), 320–322. doi:10.1016/0020-1383(92)90179-V:.PubMedCrossRef

16.

Garden, R. S. (1961). Low-angle fixation in fractures of the femoral neck. Journal of Bone and Joint Surgery, 43, 647–663.

17.

Owens, W. D., Felts, J. A., & Spitznagel, E. L., Jr. (1978). ASA physical status classifications: A study of consistency of ratings. Anesthesiology, 49(4), 239–243.PubMedCrossRef

18.

Brooks, R. (1996). EuroQol: The current state of play. Health Policy, 37, 53–72. doi:10.1016/0168-8510(96)00822-6.PubMedCrossRef

19.

Dolan, P., Gudex, C., Kind, P., & Williams, A. (1996). The time trade-off method: Results from a general population study. Health Economics, 5(2), 141–154.PubMedCrossRef

20.

Brazier, J. E., Walters, S. J., Nicholl, J. P., & Kohler, B. (1996). Using the SF-36 and Euroqol on an elderly population. Quality of Life Research, 5(2), 195–204. doi:10.1007/BF00434741.PubMedCrossRef

21.

Coast, J., Peters, T. J., Richards, S. H., & Gunnell, D. J. (1998). Use of the EuroQoL among elderly acute care patients. Quality of Life Research, 7(1), 1–10. doi:10.1023/A:1008857203434.PubMedCrossRef

22.

Tidermark, J., & Bergström, G. (2007). Responsiveness of the EuroQol (EQ-5D) and the Nottingham Health Profile (NHP) in elderly patients with femoral neck fractures. Quality of Life Research, 16(2), 321–330. doi:10.1007/s11136-006-9004-4.PubMedCrossRef

23.

Tidermark, J., Bergström, G., Svensson, O., Törnkvist, H., & Ponzer, S. (2003). Responsiveness of the EuroQol (EQ5-D) and the SF-36 in elderly patients with displaced femoral neck fractures. Quality of Life Research, 12(8), 1069–1079. doi:10.1023/A:1026193812514.PubMedCrossRef

24.

Borgström, F., Zethraeus, N., Johnell, O., Lidgren, L., Ponzer, S., Svensson, O., et al. (2006). Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporosis International, 17(5), 637–650. doi:10.1007/s00198-005-0015-8.PubMedCrossRef

25.

Gueorguieva, R., & Krystal, J. H. (2004). Move over ANOVA: Progress in analyzing repeated-measures data and its reflection in papers published in the archives of general psychiatry. Archives of General Psychiatry, 61(3), 310–317.PubMedCrossRef

26.

Forsythe, M. E., Whitehouse, S. L., Dick, J., & Crawford, R. W. (2007). Functional outcomes after nonrecurrent dislocation of primary total hip arthroplasty. Journal of Arthroplasty, 22(2), 227–230. doi:10.1016/j.arth.2006.06.003.PubMedCrossRef

27.

Baker, R. P., Squires, B., Gargan, M. F., & Bannister, G. C. (2006). Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. Journal of Bone and Joint Surgery. American Volume, 88(12), 2583–2589. doi:10.2106/JBJS.E.01373.CrossRef

28.

Tidermark, J., Zethraeus, N., Svensson, O., Törnkvist, H., & Ponzer, S. (2002). Femoral neck fractures in the elderly: Functional outcome and quality of life according to EuroQol. Quality of Life Research, 11(5), 473–481. doi:10.1023/A:1015632114068.PubMedCrossRef

29.

MacKenzie, E. J., Cushing, B. M., Jurkovich, G. J., Morris, J. A., Burgess, A. R., deLateur, B. J., et al. (1993). Physical impairment and functional outcomes six months after severe lower extremity fractures. Journal of Trauma, 34(4), 528–538.PubMedCrossRef

30.

Burström, K., Johannesson, M., & Diderichsen, F. (2001). Swedish population health-related quality of life results using the EQ-5D. Quality of Life Research, 10(7), 621–635. doi:10.1023/A:1013171831202.PubMedCrossRef

Titel: Quality of life after dislocation of hip arthroplasty: a prospective cohort study on 319 patients with femoral neck fractures with a one-year follow-up
Auteurs: Anders Enocson
Hans Pettersson
Sari Ponzer
Hans Törnkvist
Nils Dalén
Jan Tidermark
Publicatiedatum: 01-11-2009
Uitgeverij: Springer Netherlands
Gepubliceerd in: Quality of Life Research / Uitgave 9/2009
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-009-9531-x

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Purpose

Methods

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 9/2009

Factors associated with health-related quality of life after successful kidney transplantation: a population-based study

The comparative responsiveness of the EQ-5D and SF-6D to change in patients with inflammatory arthritis

Impaired parent-reported quality of life in treatment-seeking children with obesity is mediated by high levels of psychopathology

SF-36 includes less Parkinson Disease (PD)-targeted content but is more responsive to change than two PD-targeted health-related quality of life measures

Qualitative research and content validity: developing best practices based on science and experience

Determinants of global quality of life before and after major cancer surgery: an exploratory study