Differences in the views of orthopaedic surgeons and referring practitioners on the determinants of outcome after total hip replacement

Author:

Stürmer T.1,Dreinhöfer K.2,Gröber-Grätz D.2,Brenner H.3,Dieppe P.4,Puhl W.2,Günther K.-P.5

Affiliation:

1. Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02120, USA.

2. Department of Orthopaedic Surgery, Rehabilitationskrankenhaus Ulm University of Ulm, 89081 Ulm, Germany.

3. Department of Epidemiology, German Centre for Research on Ageing, 69115 Heidelberg, Germany.

4. Medical Research Council’s Research Collaboration, Department of Social Medicine University of Bristol, Bristol BS8 2PR, UK.

5. Department of Orthopaedic Surgery University of Dresden, 07307 Dresden, Germany.

Abstract

In order to assess current opinions on the long-term outcome after primary total hip replacement, we performed a multicentre, cross-sectional survey in 22 centres from 12 European countries. Different patient characteristics were categorised into ‘decreases chances’, ‘does not affect chances’, and ‘increases chances’ of a favourable long-term outcome, by 304 orthopaedic surgeons and 314 referring practitioners. The latter were less likely to associate age older than 80 years and obesity with a favourable outcome than orthopaedic surgeons (p < 0.001 and p = 0.006, respectively) and more likely to associate age younger than 50 years with a favourable outcome (p = 0.006). Comorbidity, rheumatoid arthritis, and poor bone quality were thought to be associated with a decreased chance of a favourable outcome. We found important differences in the opinions regarding long-term outcome after total hip replacement within and between referring practitioners and orthopaedic surgeons. These are likely to affect access to and the provision of total hip replacement.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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