Is There Agreement Between Clinical Outcomes as Perceived by the Surgeon and the Patient in Revision Total Hip Arthroplasty?
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.006 | 0.034 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".