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Patients May Live Longer After Total Hip Replacement: Study suggests the procedure can add years to life and "add life to years.".

Hip replacement surgery among older adults does more than relieve pain and improve range of motion, according to a large study in Sweden. It may also add to life expectancy.

The new findings were published online Feb. 28, 2018, in Clinical Orthopaedics and Related Research.

98 Percent Success Rate. More than 300,000 total hip replacements are performed each year in the U.S., and the procedure has a 98 percent success rate--one of the highest in orthopaedic surgery. Twenty years following surgery, more than 80 percent of implants are still functioning properly.

Total hip arthroplasty (THA) relieves pain, provides greater range of motion and allows the patient to return to normal daily activities. Some return to very active lifestyles and demanding recreational activities.

In 85 percent of cases, the problem is osteoarthritis, which wears away the articular cartilage in the ball and socket joint of the hip. The other 15 percent of surgeries are performed because of conditions such as rheumatoid arthritis and death of bone tissue (necrosis) at the top of the femur--the large bone in the upper leg.

Encouraging Results. Researchers in Sweden analyzed data on approximately 132,000 patients who had undergone THA over a 14-year period. The average age at the time of hip replacement was 68.

During the study's follow-up period, 16.5 percent of the patients died, but survival after THA was larger than expected when compared to people of the same age and gender in the Swedish population.

In the first year following surgery, survival was 1 percent higher in THA patients than the matched population. In the next five years, the difference increased to 3 percent and dropped back to 2 percent after 10 years. At the 12-year mark, survival rates were no different for THA patients than other people in the same age group.

In 91 percent of cases the survival difference was noted primarily among patients who underwent the surgery because of advanced osteoarthritis. In those who had hip surgery to remedy other conditions, survival was lower than in the general population. Patients who had accompanying medical conditions also had lower survival rates.

One limitation of the study is that only patients in relatively good health are selected for the THA.

Survival Rates Are Improving. The research team noted "strong indications" that patient survival following THA is improving, and that those who have THA tend to live longer than people of similar ages in Sweden's general population. The added life expectancy advantage lasts for approximately 10 years.

Lead author Peter Cnudde, MD, of the Swedish Hip Arthroscopy Register, said, "No surgeon would recommend total hip arthroscopy for patients just to live longer, but it is likely that the chances of surviving longer are associated with undergoing a successful operation among patients in need of a hip replacement."

An accompanying article in the journal written by Hannes Rudiger, MD, of the Schulthess Clinic in Zurich, Switzerland, said the study provides new insights into the lifelong health benefits and economic value of THA. As the procedure is performed on younger patients, information on the long-term rates of repeat surgery will be essential.

More Data Needed to Advise Patients. Dr. Cnudde added, "As surgeons, we need more data in order to advise patients about what one can and cannot expect from an intervention that involves THA, as well as how it will affect them for the rest of their lives." DM
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Publication:Duke Medicine Health News
Geographic Code:4EUSW
Date:Jun 1, 2018
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