Is There Agreement Between Clinical Outcomes as Perceived by the Surgeon and the Patient in Revision Total Hip Arthroplasty?
Notice bibliographique
Résumé
Objectives: Revision total hip arthroplasty (rTHA) is a complex surgery with variable functional outcomes that often differ between the surgeon’s perception and the patient’s experience. Therefore, the aim of this study is, first, to evaluate functional outcomes based on the reason for revision, type of revision, acetabular defect, and number of prior revision surgeries; and second, to compare outcomes from both the surgeon’s and the patient’s perspectives to determine whether or not there is agreement between them. Materials and Methods: An observational study was conducted on patients who underwent rTHA at a tertiary-level center from January 2013 to December 2018, with a median follow-up of 41 months. A total of 149 procedures were performed during this period. The variables analyzed included the indication for revision surgery, type of revision, presence of acetabular defect, and number of previous revision surgeries. The surgeon’s perspective was assessed using the Harris Hip Score (HHS), while the patient’s perspective was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-12 Health Survey (SF-12). Results: Analysis of the variables from both surgeon’s and patient’s perspectives showed statistically significant differences regarding the indication for revision and the SF-12 component, with patients undergoing revision for infection or dislocation reporting worse functional outcomes. Although the remaining variables did not reach statistical significance, the surgeon perceived worse outcomes in patients revised for infection and in those who underwent revision of both components (acetabular and femoral). Conversely, patients reported poorer functional outcomes when operated on for infection or dislocation, when both components were revised, and when they had undergone more than one revision surgery. Additionally, a statistically significant trend was observed showing worse outcomes with increasing anesthetic risk. Linear regression analysis between the surgeon’s evaluation and the patient-reported outcome measures showed a statistically significant association, indicating that higher surgeon scores correlated with fewer symptoms and better hip function as reported by patients. Conclusion: There was concordance between the surgeon’s evaluation, measured by the Harris Hip Score (HHS), and the patient’s perception of health status through PROMs, specifically the SF-12 and WOMAC questionnaires. Although overall results were satisfactory regardless of the reason for the revision, type of revision, defect grade, or number of revisions; outcomes were slightly worse in patients revised for dislocation or infection, those undergoing revisions of both components, and in cases involving multiple revision surgeries.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,034 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».