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Differences in the views of orthopaedic surgeons and referring practitioners on the determinants of outcome after total hip replacement

¹ Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02120, USA.
² Department of Orthopaedic Surgery, Rehabilitationskrankenhaus Ulm University of Ulm, 89081 Ulm, Germany.
³ Department of Epidemiology, German Centre for Research on Ageing, 69115 Heidelberg, Germany.
⁴ Medical Research Council’s Research Collaboration, Department of Social Medicine University of Bristol, Bristol BS8 2PR, UK.
⁵ Department of Orthopaedic Surgery University of Dresden, 07307 Dresden, Germany.

Correspondence should be sent to Dr K.-P. Günther; e-mail: klaus-peter.guenther{at}mailbox.tu-dresden.de

In order to assess current opinions on the long-term outcome after primary total hip replacement, we performed a multicentre, cross-sectional survey in 22 centres from 12 European countries. Different patient characteristics were categorised into ‘decreases chances’, ‘does not affect chances’, and ‘increases chances’ of a favourable long-term outcome, by 304 orthopaedic surgeons and 314 referring practitioners. The latter were less likely to associate age older than 80 years and obesity with a favourable outcome than orthopaedic surgeons (p < 0.001 and p = 0.006, respectively) and more likely to associate age younger than 50 years with a favourable outcome (p = 0.006). Comorbidity, rheumatoid arthritis, and poor bone quality were thought to be associated with a decreased chance of a favourable outcome. We found important differences in the opinions regarding long-term outcome after total hip replacement within and between referring practitioners and orthopaedic surgeons. These are likely to affect access to and the provision of total hip replacement.

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