NEW YORK (Reuters Health), Nov 29 - The substantial benefits of total hip arthroplasty (THA) for osteoarthritis are sustained in the long-term, according to a follow-up study lasting up to 10 years after the original surgery, British investigators report in the December 15 issue of Arthritis Care and Research.
The short-term efficacy of hip replacement surgery has been well-documented, principal investigator Dr. Cyrus Cooper and his associates note, but there are few data looking at durability of the benefits or the predictors of outcome.
In 1998, Dr. Cooper, at the University of Southampton, and his team reported the results of a case-control study involving 643 osteoarthritis patients, who underwent THA in the early 1990s, and 643 matched controls. Their current report involves follow-up (6.5 to 9.9 years, average 8.3 years) for 282 of the original patients and 295 controls.
According to responses on Short-Form 36 questionnaires, physical function scores improved from 20 at baseline to 30 at follow-up in the THA group and declined from 85 to 65 in the controls (p < 0.0001). Vitality scores fell from 60 to 50 in the THA group, while remaining at 60 in the controls. Scores on mental health improved by 12 points in both groups.
"Even when allowance is made for possible confounding effects, the long-term improvement in the physical functioning of the cases is striking when set against the decline that occurred in controls," Dr. Cooper and his associates observe.
They found that higher radiographic grade prior to surgery was a strong predictor of improvement in physical functioning: Among patients with grade 5 osteoarthritis, the physical function score increase averaged 19.4 points higher than in patients with osteoarthritis grades 0 to 3.
"There may, therefore, be a case for giving higher priority to patients with severe radiographic changes," they say.
While having a BMI up to 30 had no effect on outcome, "further evidence is needed in the prognostic influence of more severe obesity," the researchers conclude.
Last Updated: 2007-11-29 11:09:48 -0400 (Reuters Health)
Arthritis Care and Research 2007;57:1375-1380.
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
