Indikationskriterien zur Implantation einer Hüftendoprothese - im europäischen Vergleich
LicenseStandard (Fassung vom 03.05.2003)
Objectives: Hip replacement is a good and cost-effective treatment but there is no consensus about optimal timing of THR and factors influencing indications in different countries. The aim of this study was to identify if there are different opinions about indication criterias of primary total hip replacement within and between orthopaedic surgeons and referring physicians in Europe. Methods: In a multicentre cross-sectional postal survey 22 orthopaedic centres in 12 European countries participated 304 orthopaedic surgeons and 314 referring physicians. A standardized questionnaire regarding treatment opinions about THR was sent out. Each participant was asked about his opinion to determinants of long-term outcome after total hip replacement, the influence of patient characteristics and the importance of different domains like pain, radiographs and functional impairment (medical indication) for their decision to untertake THR. Results: We found essential differences within and between orthopaedic surgeons and referring physicians regarding a favourable outcome (e.g. age, hipdysplasia, rheumatoide arthritis, poor bone quality), patients´ characteristics (e.g. dementia, comorbidity, chronic depression, functions) and medical indication (e.g. radiographic, functional status). Criterias like pain, rest pain and pain with activity were most important for the indicaton of THR. Conclusion: It doesn´t currently exist consensus about objective criterias for the indication of primary hip replacement on European level.The lack of consensus regarding indication could be a reason for the variations in the rates of THR. Even though the differences could be pointed out this may partially be referred to the health and social system and also to the characteristic values and concepts of the particular country.
Subject HeadingsHüftgelenkprothese [GND]
Arthroplasty, replacement, hip [MeSH]