Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis
Background and purpose: This study introduces an innovative research design in the field of orthopedics, using a target trial emulation approach. We aimed to assess the causal effects of total hip arthroplasty (THA) compared with nonoperative treatment in reducing patient-reported hip disability at...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-04-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/43332 |
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| author | Amanda D Klaassen Wiard Jorritsma Nienke W Willigenburg Carina L E Gerritsma Bas L E F Ten Have Dirk Jan F Moojen Maaike G J Gademan Rolf H H Groenwold Rudolf W Poolman |
| author_facet | Amanda D Klaassen Wiard Jorritsma Nienke W Willigenburg Carina L E Gerritsma Bas L E F Ten Have Dirk Jan F Moojen Maaike G J Gademan Rolf H H Groenwold Rudolf W Poolman |
| author_sort | Amanda D Klaassen |
| collection | DOAJ |
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Background and purpose: This study introduces an innovative research design in the field of orthopedics, using a target trial emulation approach. We aimed to assess the causal effects of total hip arthroplasty (THA) compared with nonoperative treatment in reducing patient-reported hip disability at 3 months in patients with osteoarthritis, using real-world data.
Methods: We emulated a target trial using real-world data of 2 Dutch hospitals between April 2020 and January 2022. Patients diagnosed with hip osteoarthritis and eligible for primary THA were included in the study. During the COVID-19 pandemic, THA was often cancelled due to external factors (i.e., limited operating room capacity, or surgeon unavailable due to quarantine rules), resulting in an arbitrary allocation of patients to THA (n = 132) or non-THA (n = 60). We compared changes in hip disability, measured using the Hip disability and Osteoarthritis Outcome Score Physical function Short form (HOOS-PS), between the THA group at 3 months postoperatively and the non-THA group at ≥3 months post waiting-list. Linear regression analysis, adjusting for potential confounders, was used to compare between-group differences.
Results: THA showed preferable outcomes compared with non-THA, indicated by a difference of –33 points (95% confidence interval [CI] –37 to –28) on the HOOS-PS. Patients in the THA group demonstrated a clinically significant improvement in hip function, with a mean change of –27 points (CI –31 to –24), while the control group showed no improvement with a mean change of 7 points (CI 3–11) on the HOOS-PS.
Conclusion: THA significantly improves hip function in osteoarthritis patients, surpassing the outcomes observed in the non-surgery group.
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| format | Article |
| id | doaj-art-fe54c72e62834713aa5eee670b7046bf |
| institution | OA Journals |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-fe54c72e62834713aa5eee670b7046bf2025-08-20T02:12:07ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822025-04-019610.2340/17453674.2025.43332Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritisAmanda D Klaassen0https://orcid.org/0000-0002-8499-2814Wiard Jorritsma1Nienke W Willigenburg2Carina L E Gerritsma3Bas L E F Ten Have4Dirk Jan F Moojen5Maaike G J Gademan6https://orcid.org/0000-0002-6106-3385Rolf H H Groenwold7Rudolf W Poolman8https://orcid.org/0000-0003-3178-2247Department of Orthopedic Surgery, Joint Research, OLVG Hospital, Amsterdam; Department of Orthopedics, Leiden University Medical Center, Leiden; Santeon Better Together Value-Based Health Care (VBHC) Program, Utrecht, the NetherlandsSanteon Better Together Value-Based Health Care (VBHC) Program, Utrecht; Department of Quality and Improvement, OLVG Hospital, Amsterdam, the NetherlandsDepartment of Orthopedic Surgery, Joint Research, OLVG Hospital, Amsterdam, the NetherlandsSanteon Better Together Value-Based Health Care (VBHC) Program, Utrecht; Department of Orthopedic Surgery, Martini Hospital, Groningen, the NetherlandsSanteon Better Together Value-Based Health Care (VBHC) Program, Utrecht; Department of Orthopedic Surgery, Martini Hospital, Groningen, the NetherlandsDepartment of Orthopedic Surgery, Joint Research, OLVG Hospital, Amsterdam, the Netherlandsepartment of Orthopedics, Leiden University Medical Center, Leiden; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Orthopedic Surgery, Joint Research, OLVG Hospital, Amsterdam; Department of Orthopedics, Leiden University Medical Center, Leiden; Santeon Better Together Value-Based Health Care (VBHC) Program, Utrecht, the Netherlands Background and purpose: This study introduces an innovative research design in the field of orthopedics, using a target trial emulation approach. We aimed to assess the causal effects of total hip arthroplasty (THA) compared with nonoperative treatment in reducing patient-reported hip disability at 3 months in patients with osteoarthritis, using real-world data. Methods: We emulated a target trial using real-world data of 2 Dutch hospitals between April 2020 and January 2022. Patients diagnosed with hip osteoarthritis and eligible for primary THA were included in the study. During the COVID-19 pandemic, THA was often cancelled due to external factors (i.e., limited operating room capacity, or surgeon unavailable due to quarantine rules), resulting in an arbitrary allocation of patients to THA (n = 132) or non-THA (n = 60). We compared changes in hip disability, measured using the Hip disability and Osteoarthritis Outcome Score Physical function Short form (HOOS-PS), between the THA group at 3 months postoperatively and the non-THA group at ≥3 months post waiting-list. Linear regression analysis, adjusting for potential confounders, was used to compare between-group differences. Results: THA showed preferable outcomes compared with non-THA, indicated by a difference of –33 points (95% confidence interval [CI] –37 to –28) on the HOOS-PS. Patients in the THA group demonstrated a clinically significant improvement in hip function, with a mean change of –27 points (CI –31 to –24), while the control group showed no improvement with a mean change of 7 points (CI 3–11) on the HOOS-PS. Conclusion: THA significantly improves hip function in osteoarthritis patients, surpassing the outcomes observed in the non-surgery group. https://actaorthop.org/actao/article/view/43332Arthroplasty HipTarget Trial Emulation |
| spellingShingle | Amanda D Klaassen Wiard Jorritsma Nienke W Willigenburg Carina L E Gerritsma Bas L E F Ten Have Dirk Jan F Moojen Maaike G J Gademan Rolf H H Groenwold Rudolf W Poolman Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis Acta Orthopaedica Arthroplasty Hip Target Trial Emulation |
| title | Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis |
| title_full | Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis |
| title_fullStr | Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis |
| title_full_unstemmed | Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis |
| title_short | Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis |
| title_sort | effectiveness of total hip arthroplasty versus non surgery on patient reported hip function at 3 months a target trial emulation study of patients with osteoarthritis |
| topic | Arthroplasty Hip Target Trial Emulation |
| url | https://actaorthop.org/actao/article/view/43332 |
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