A Matched Comparison of the Rates of Achieving the Minimal Clinically Important Difference Following Conversion and Primary Total Hip Arthroplasty.

BACKGROUND: Patient-reported outcome measures (PROMs) are often lower following conversion total hip arthroplasty (cTHA) compared to matched primary THA controls. However, the minimal clinically important differences (MCIDs) for any PROMs have yet to be analyzed for cTHA. This study aimed to 1) Determine if patients undergoing cTHA achieve primary THA-specific 1-year PROM MCIDs at comparable rates to matched controls undergoing primary THA and 2) Establish 1-year MCID values for specific PROMs following cTHA.

METHODS: A retrospective case-control study was conducted utilizing 148 cases of cTHA which were matched 1:2 to 296 primary THA patients. Previously defined anchor values for two PROM measures in primary THA were utilized to compare cTHA to primary THA, while novel cTHA-specific MCID values for two PROMs were calculated through a distribution method. Predictors of achieving the MCID of PROMs were analyzed through multivariate logistic regressions.

RESULTS: Conversion THA was associated with decreased odds of achieving the primary THA-specific 1-year Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement PROM (Odds Ratio (OR):0.319, 95% Confidence Interval (CI):0.182-0.560, P<0.001) and Patient Reported Outcomes Measurement Information System Physical Function Short-Form-10a PROM (OR:0.531, 95% CI:0.313-0.900, P=0.019) MCIDs in reference to matched primary THA patients.Less than 60% of cTHA patients acheived a MCID. The 1-year MCID of the HOOS, JR and PROMIS-PF-SF-10a specific to cTHA were +10.71 and +4.68, respectively.

CONCLUSION: While cTHA is within the same diagnosis related group as primary THA, patients undergoing cTHA have decreased odds of achieving 1-year MCIDs of primary THA-specific PROMs.