Surgeons Prefer Partial Hip Replacement. New Study Shows That Patients Don’t

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The choice between total hip arthroplasty (THA) and hemiarthroplasty is controversial, although studies show that about 85% of surgeons favor the latter for its simplicity and reduced risk of dislocation. Until now, few people have asked the patients for their preference. Canadian researchers have carried out a rigorous decision analysis among people over 60 at an osteoporosis clinic. Overwhelmingly, patients at risk of hip fracture hold the opposite opinion: They prefer total hip replacement for its reduced pain and better postoperative function. The study is from McMaster University in Ontario.

RESULT: Surgical preferences of patients at risk of hip fractures: hemiarthroplasty versus total hip arthroplasty
BMC Musculoskeletal Disorders | Dec 23, 2011 (FREE FULL TEXT)



That said, there’s a need for better information about outcomes of THA, according to authors of this recent report in JAMA. The picture may not be as rosy as the Canadian patients seem to think, at least not in the US. A survey of Medicare data has encouraging results: Postoperative mortality has fallen over the past two decades. However, a corresponding reduction in postoperative length of stay has been associated with an increase in readmission rates and a reduction in the proportion of patients discharged directly to their homes.

RESULT: Clinical Characteristics and Outcomes of Medicare Patients Undergoing Total Hip Arthroplasty, 1991-2008
JAMA | Apr 20, 2011 (FREE FULL TEXT)