Galvain, T, Mantel, J, Kakade, O and Board, TN (2022) Treatment patterns and clinical and economic burden of hip dislocation following primary total hip arthroplasty in England. The Bone & Joint Journal, 104 B (7). pp. 811-819. ISSN 2049-4394

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Abstract

Aims The aim of this study was to estimate the clinical and economic burden of dislocation following primary total hip arthroplasty (THA) in England. Methods This retrospective evaluation used data from the UK Clinical Practice Research Datalink database. Patients were eligible if they underwent a primary THA (index date) and had medical records available 90 days pre-index and 180 days post-index. Bilateral THAs were excluded. Healthcare costs and resource use were evaluated over two years. Changes (prevs post-THA) in generic quality of life (QoL) and joint-specific disability were evaluated. Propensity score matching controlled for baseline differences between patients with and without THA dislocation. Results Among 13,044 patients (mean age 69.2 years (SD 11.4), 60.9% female), 191 (1.5%) had THA dislocation. Two-year median direct medical costs were £15,333 (interquartile range (IQR) 14,437 to 16,156) higher for patients with THA dislocation. Patients underwent revision surgery after a mean of 1.5 dislocations (1 to 5). Two-year costs increased to £54,088 (IQR 34,126 to 59,117) for patients with multiple closed reductions and a revision procedure. On average, patients with dislocation had greater healthcare resource use and less improvement in EuroQol five-dimension index (mean 0.24 (SD 0.35) vs 0.44 (SD 0.35); p < 0.001) and visual analogue scale (0.95 vs 8.85; p = 0.038) scores, and Oxford Hip Scores (12.93 vs 21.19; p < 0.001). Conclusion The cost, resource use, and QoL burden of THA dislocation in England are substantial. Further research is required to understand optimal timing of revision after dislocation, with regard to cost-effectiveness and impact on QoL.

Item Type:	Article
Uncontrolled Keywords:	Humans; Hip Dislocation; Arthroplasty, Replacement, Hip; Reoperation; Retrospective Studies; Hip Prosthesis; Quality of Life; Aged; Female; Male; Joint Dislocations; Financial Stress; Cost; Dislocation; Healthcare resource use; Oxford Hip Score (OHS); Quality of life; THA dislocation; Total hip arthroplasty; closed reductions; hip dislocation; primary total hip arthroplasty; propensity score matching; revision surgery; t-test; total hip arthroplasty (THA); visual analogue scale; Aged; Arthroplasty, Replacement, Hip; Female; Financial Stress; Hip Dislocation; Hip Prosthesis; Humans; Joint Dislocations; Male; Quality of Life; Reoperation; Retrospective Studies
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Computer Science and Mathematics
Publisher:	British Editorial Society of Bone & Joint Surgery
SWORD Depositor:	A Symplectic
Date Deposited:	22 Nov 2024 14:52
Last Modified:	22 Nov 2024 15:00
DOI or ID number:	10.1302/0301-620X.104B7.BJJ-2021-1732.R1
URI:	https://researchonline.ljmu.ac.uk/id/eprint/24845

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