Patient-reported quality of life and hip function after 2-stage revision of chronic periprosthetic hip joint infection: a cross-sectional study

Abstract

Introduction: Very limited information is available regarding patient-reported health-related quality of life (HRQoL) and hip function following treatment for chronic periprosthetic hip joint infection (PJI). Patient-reported outcome measures provide essential information to clinicians of the impact a treatment have on patient’s lives. The purpose of this study was to examine patient reported HRQoL and hip function after a completed re-implantation in a 2-stage revision. Method: 82 patients were identified retrospectively in the National Patient Register. 57 patients were alive and asked to complete the questionnaires EuroQol-5D (EQ-5D) and Oxford Hip Score (OHS) in November 2014. Results were compared to normative population data for EQ-5Dindex. Patients re-infected after a completed 2-stage revision were compared with not re-infected. Results: 45 patients completed the questionnaires. Mean time since re-implantation was 8.2 years (95% CI [confidence interval], 7.7-0.87). The EQ-5D index mean for the 2-stage group was 0.71 (0.64; 0.77) whereas the general population mean is 0.85 (0.84-0.85), p = 0.0004. The 2-stage revision patients scored significantly lower on every EQ-5D dimension. The re-infected group mean EQ-5D index score was significantly lower compared to the not re-infected group, p = 0.003. The EQ-VAS mean score was 58.2 (57.3-68.3) and the mean OHS for the group was 29.2 (25.4-33.0). Conclusions: Patients who undergo 2-stage revision after a PJI have lower scores on HRQoL than the general population. Patients who are re-infected following revision have a lower HRQoL score than patients not re-infected. Future research should focus on optimising patient-reported outcomes after treatment for PJI.