Can a surgeon predict the longevity of a total hip replacement?

Abstract

Introduction: The purpose of this study was to examine the ability of a surgeon to predict survival of a total hip replacement (THR) based on the patient's diagnosis, demographics, postoperative activity level and the surgical technique.

Methods: 4 experienced hip surgeons were asked to predict the longevity of 131 Charnley THRs, performed by the senior author (GH) 22-35 years ago, by providing them with pre- and postoperative radiographs, and data concerning patient's diagnosis, demographics, postoperative activity level and the surgical technique. This process was repeated 3 months later.

Results: There was only a slight agreement between the majority of the predictions and actual outcome. The inter-observer agreement was also slight and intra-observer agreement ranged from slight to moderate.

Conclusion: We confirmed that surgeons are unable to determine the life expectancy of the implants of a THR, based on the aforementioned data, because there are other non-identified factors that affect the survivorship of a THR. For this reason, regular follow-up remains the safest way to evaluate patients' clinical picture and the evolution of radiographic changes, if there are any, in order to accurately advise patients and decide on the appropriate time for revision.

Keywords: Inter-observer agreement; Kappa coefficient; Low friction arthroplasty; prediction of survival; total hip arthroplasty survival; total hip replacement survival.