Original ArticlesMortality, morbidity, and 1-year outcomes of primary elective total hip arthroplasty*,**,★
Section snippets
Methods
All consultant orthopaedic surgeons in 5 U.K. regions (East Anglia, Oxford, Trent, Northern, and Yorkshire) were invited to participate, by supplying operative data about every primary elective THA operation in National Health Service (NHS) and private hospitals during a 12-month period in 1996–1997. Consecutive patients listed for THA were asked to complete questionnaires preoperatively and at 3 and 12 months postoperatively. These questionnaires included the 12 items of the Oxford Hip Score
Results
Of 379 surgeons thought to be undertaking THA surgery at that time, 300 (79%) agreed to participate, 13 (3%) refused to participate, and 66 (17%) did not reply to the request to participate in this study. Data were collected from 143 hospitals, with 1 NHS and 2 private hospitals refusing to take part. The total number of THA operations carried out in participating hospitals during the study period was estimated from operating room records to be 13,343 (10,948 NHS and 2,395 private), and a
Discussion
Improvements in health status and mobility, as measured by the use of the OHS [13] and other questionnaires, can be used to assess the positive outcomes of hip surgery. In this study, large and important overall improvements in symptoms were observed 16, 17. It is equally important, however, for patients and surgeons to consider the risk of adverse outcomes when making a decision to undergo THA, and it has been recommended that deaths occurring within 3 months of operation, revision rates, and
Conclusion
This study provides the best information to date about the risk of adverse outcomes of THA when practiced in the general setting of the U.K. health care system. We are not aware of the availability of similar information for other countries, although other outcomes (eg, revision rates and mortality) have been reported by the Swedish and Norwegian Registries 3, 4, 19. Patients undergoing THA in the United Kingdom should have access to this information when making a decision whether to undergo
Acknowledgements
The National Total Hip Replacement Outcome Study (NTHROS) was a collaborative project between the British Orthopaedic Association and the Clinical Effectiveness Unit of the Royal College of Surgeons. We thank the research coordinators in the regions (Victoria Bridgett, June Stefanelli, Joanne Staniland, and Louisa Clements) for their help with data collection and abstraction of information from clinical records. We also thank members of the NTHROS steering committee not listed as authors: the
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Benefits or funds were received in partial or total support of the research material described in this article from the Department of Health for England and Wales.
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Reprint requests: Professor Paul J. Gregg, MD, FRCS, Middlesborough General Hospital and University of Durham, UK. E-mail: [email protected]
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On behalf of the National Total Hip Replacement Outcome Study Steering Committee.