Differences in Patient-Reported Outcome Measures Between Primary and Revision Total Hip Arthroplasty: Realistic Patient Expectations for Patients With Low Baseline Activity
Bibliographic record
Abstract
Primary total hip arthroplasty (pTHA) and revision total hip arthroplasty (rTHA) are not often compared in terms of patient-reported outcome measures (PROMs). However, surgeons and patients need to better understand the differences in PROMs between primary and revision surgery to set realistic patient expectations and recovery milestones. A matched cohort study of pTHA to rTHA was performed with our arthroplasty database of a single surgeon's experience from 2012 to 2018. There was a significant difference in both pre-operative assessment and change from preoperative to postoperative assessment of the PROMs. Patients undergoing pTHA had higher visual analog scale (VAS) pain scores (67.9 vs 57.9, P =.004). Those undergoing rTHA had higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (57.1 vs 50.1, P =.008) and Veterans RAND 12 Item Health Survey (VR-12) (33.5 vs 33.1, P =.01) scores. However, a significant change was noted in the difference from preoperative to postoperative scores between the pTHA and rTHA groups: Harris Hip Score (HHS) total score (pTHA 30.7 vs rTHA 4.4, P <.001), WOMAC score (pTHA 29.3 vs rTHA 12.2, P <.001), and VAS pain score (pTHA -48.3 vs rTHA -26.5, P <.001) as well as groin pain (pTHA 1.4% vs rTHA 7.1%, P =.02). Further, PROMs after rTHA were inferior to those after pTHA with several outcome instruments, including HHS, WOMAC score, and VAS pain score. In addition, groin pain was significantly greater in the rTHA cohort compared with the pTHA cohort at the latest follow-up. This study allows surgeons and patients to better understand the differences in PROMs to set realistic patient expectations and recovery milestones. [ Orthopedics . 2022;45(4):251–255.]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".