Hip arthroplasty surveillance: Is it really needed?
Smith, Lindsay; Powell, Jane; Dures, Emma; Palmer, Shea; Lenguerrand, Erik; Beswick, Andrew; Blom, Ashley
Jane Powell Jane.Powell@uwe.ac.uk
Professor in Public Health Economics
Emma Dures Emma2.Dures@uwe.ac.uk
Associate Professor in Rheumatology and Self-management
Shea Palmer Shea.Palmer@uwe.ac.uk
Professor in Allied Health Professions
Abstract for BOA 2019
Although long-term follow up of joint replacement is advocated, in a national audit of 42 orthopaedic units, only 43% were continuing follow up beyond 5 years. Four studies were conducted using mixed methods research to address the following question: Hip arthroplasty surveillance: Is it really necessary?
1. Systematic literature review: explored evidence for clinical or cost effectiveness of long-term hip arthroplasty surveillance. 114 studies were included, but due to paucity of quantitative evidence related to the research question, qualitative techniques were used to examine expert opinion. Main findings - follow up was specifically recommended to monitor change (e.g. asymptomatic loosening), when outcomes of joint construct are unknown, and for specific patient subgroups.
2. Pilot observational study: cohort of patients undergoing revision hip arthroplasty. Baseline PROMS were collected and repeated 12 months after surgery plus health resource use in the 6 months after surgery. Results indicate that patients with follow up report a better view of health than those without 12 months after surgery, and less health resources are used in the group with follow-up.
3. Survey of health professionals: to find out current views on long-term follow-up (172 participants). 87% in favour of long-term surveillance, although 33% preferred change in time intervals and methods of delivery.
4. Patient focus groups: to find out patient view. They prefer questionnaires based on everyday life (postally or electronically), an x-ray (preferably locally), would accept a letter stating results but want periodic review with orthopaedics. All wanted telephone access back-up to orthopaedic team. They stated - no exclusions - age is not determinant of health and questionnaires can act as a self-exclusion tool.
These studies suggest that some long-term follow-up is consistent with patient-centred care but needs to be delivered using effective and timely methods which can respond to evidence emerging from orthopaedic registries.
|Start Date||Sep 10, 2019|
|Publication Date||Sep 10, 2019|
|APA6 Citation||Smith, L., Powell, J., Dures, E., Palmer, S., Lenguerrand, E., Beswick, A., & Blom, A. (2019). Hip arthroplasty surveillance: Is it really needed?|