EUROHIP (eBook)

Preface 5
Contents 7
Contributors 9
1 Introduction: The Provision of Hip Joint Replacement 12
Part I Health Technology Assessment of Hip Arthoplasty 14
2 International Variations in Hip Replacement Rates 15
2.1 Introduction 15
2.2 Methods 16
2.3 Results 18
2.4 Discussion 26
References 28
3 Health Technology Assessment of Hip Replacement 30
3.1 Background and Objectives 30
3.2 Methods 31
3.3 Results 32
3.4 Conclusions 33
References 34
4 The Economic Perspective on Joint Replacement and Equity 36
4.1 Introduction 36
4.2 How Does Economic Evaluation De. ne Whether Joint Replacement Is Worthwhile? 36
4.3 What Should Joint Replacement Be Compared to? 37
4.4 Framework of Analysis 37
4.5 Whose Costs, Outcomes and Values Are Important in Choosing Joint Replacement? 38
4.6 Who Should Receive Joint Replacement Surgery? 39
4.7 Summary 40
References 41
5 The Cost of the Procedure 42
5.1 Introduction 42
5.2 Costs 42
5.3 Cost of Total Hip Arthroplasty 43
5.4 Economic Evaluation 46
5.5 Economic Evaluation in THA 47
5.6 Strategies to Reduce Costs 49
5.7 Conclusion 51
References 52
6 Trends in Hip Replacement Rates 55
References 59
Part II Indication for Hip Replacement 61
7 Appropriateness: Consensus in the Criteria for Indications 62
7.1 Introduction 62
7.2 Appropriateness of Total Hip Replacement 62
7.3 Waiting Lists: Urgency and Appropriateness of Times to Surgery 64
7.4 Appropriateness and Unmet Need: In the Community and in the Queue 66
7.5 Conclusion 66
References 67
8 Radiographic Assessment of Indications for Total Hip Replacement 69
8.1 Is There Any Role of Radiological Assessment for Considering Total Hip Replacement? 69
8.2 Which Are the Di. erent Radiological Aspects Which Might Be of Interest when Considering Total Articular Replacement? 73
8.3 In Conclusion 74
References 74
9 Patients’ Views on Total Joint Replacement in the UK 75
9.1 Introduction 75
9.2 Methodology 75
9.3 Results 76
9.4 Discussion 80
References 81
10 Population Requirement for Primary Hip-Replacement Surgery in England: A Comparison with Knee-Replacement 82
10.1 Introduction 82
10.2 Patients and Methods 83
10.3 Results 85
10.4 Discussion 86
References 88
Part III Outcome Measurement 89
11 What Are the Outcomes After Hip Joint Replacement for OA? 90
References 93
12 Outcomes of Hip Replacement Vary 94
12.1 The Definition of a Result 94
12.2 Individual Change 94
12.3 Why Does Outcome Vary? 95
12.4 Radiographic Stage of OA 96
12.5 Waiting Time 97
12.6 Determinants of Poor Outcome 97
References 98
13 Evaluation of the Implant 100
13.1 Introduction 100
13.2 Radiographic Assessment of Loosening 101
13.3 Stress Shielding 101
13.4 Assessment of Bony Ingrowth 102
13.5 Radiographic Assessment of Bone Destruction 102
13.7 Implant Position 103
13.8 Migration Measurement 103
References 104
14 Result Analysis of Hip Arthroplasty Registers 105
14.1 National Hip Arthroplasty Registers and Their Objective 105
14.2 Structure of Arthroplasty Registers 108
14.3 Requirements on Documentation 109
14.4 Acceptance, Compliance and Transparency 110
14.5 Parameters, Items 111
14.6 Evaluation of Factors In. uencing Survival of THA 111
14.7 Result Processing 114
14.8 Outcome Key Parameters 115
14.9 Comparison and Linkage of Registers 117
14.10 Bene. ts and Advantages of AR 117
14.11 International Registers 121
References 121
15 The Patient’s View: Indicators of Subjective Health and Their Use in Outcome Assessment 126
15.1 Introduction 126
15.2 Patient-Reported Outcomes in Musculoskeletal Medicine 127
15.3 The Patient’s View in Studies of Outcomes of Joint Replacement Surgery 129
15.4 Conclusion 130
References 131
16 The Perspectives when Assessing Function in Patients with Osteoarthritis 133
References 142
17 Conclusions: Where Do We Go from Here? 144
Participants of the EUROHIP Project 146