Authors: Maxime Samson JeanFrancis Maillefert Carine Roy Christian Cadet Philippe Ravaud
Publish Date: 2012/06/02
Volume: 31, Issue: 9, Pages: 1301-1307
Abstract
There is no consensus regarding indications for total hip arthroplasty THA in hip osteoarthritis OA Patients can be referred to surgeons either by a general practitioner GP or a rheumatologist The aim of this study was to determine whether patients referred to orthopedic surgeons by GP and rheumatologists differed GPs and rheumatologists were asked to include one patient suffering from hip OA for whom a consultation with a surgeon was planned to determine if THA was indicated Surgeons’ decisions were obtained by followup questionnaires Univariate and then multivariate statistical analysis evaluated differences between patients referred by GPs and those referred by rheumatologists A total of 558 patients were included THA was prescribed in 716 of patients referred by rheumatologists vs 576 of patients referred by GPs p = 0008 Patients referred by rheumatologists were younger 663 vs 693 years p = 0006 less frequently retired 729 vs 842 p = 0007 and presented with a higher New Zealand score 543 vs 481 p = 00009 On multivariate analysis the variables related to patients referred by rheumatologists were the SF12 mental score the New Zealand score and the surgeon’s decision Patients consulting a surgeon to discuss THA were more likely to be operated on when referred by a rheumatologist which might be due to differences in the rheumatologists’ and GPs’ opinions on the right time to perform surgery or due to differences in the populations followed by rheumatologists and GPs those followed by rheumatologists being younger more active more urban with a greater willingness to undergo surgery
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