Patients may live longer after hip replacement

Patients may live longer after hip replacement

Hip replacement surgery not only improves quality of life but is also associated with increased life expectancy, compared to people of similar age and sex, reports a study in Clinical Orthopaedics and Related Research, a publication of The Association of Bone and Joint Surgeons.

A decade after surgery, patients undergoing elective total hip arthroplasty (THA) have a slightly improved survival rate compared to the general population, according to the study by Peter Cnudde, of the Swedish Hip Arthroplasty Register, Gothenburg, and colleagues. Cnudde commented: “Our study suggests that hip replacement can add years to life as well as adding ‘life to years’, increasing the chances of longer survival as well as improving the quality of life.”

The researchers analysed postoperative survival rate in nearly 132,000 patients undergoing THA in Sweden from 1999 to 2012. Average age at hip replacement was 68 years. During a median follow-up of 5.6 years, about 16.5 per cent of patients died.

Survival after THA was longer than expected, compared to people of similar age and sex in the Swedish general population. In the first year, survival was one per cent better in THA patients versus the matched population.

The difference increased to three per cent at five years, then decreased to two per cent at 10 years. By 12 years, survival was no longer different between the two groups.

The survival difference was significant mainly among patients diagnosed with primary osteoarthritis. This condition, reflecting age-related “wear and tear”, accounted for 91 per cent of patients undergoing THA. In patients with certain other diagnoses, including osteonecrosis, inflammatory arthritis, and “secondary” osteoarthritis due to other health conditions or risk factors, survival after THA was lower compared to the general population.

Not surprisingly, patients with more accompanying medical conditions had lower survival after THA. Lower education and single marital status were also associated with lower survival.

The researchers note “strong indications” that patients’ survival after THA is improving, and that patients undergoing THA tend to live longer than a matched general population. The new findings support that impression, showing a small but significant improvement in expected survival in patients undergoing THA.

Source: Wolters Kluwer Health

Reference: Cnudde, Peter, and others. Do Patients Live Longer After THA and Is the Relative Survival Diagnosis-specific? Clinical Orthopaedics and Related Research, 2018; DOI: 10.1007/s11999.0000000000000097

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