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Outcome of Total Hip Replacement in Japan and England: Comparison of Two Retrospective Cohorts

Published online by Cambridge University Press:  10 March 2009

Kyoko Imamura  and
Nick Black
Kyoko Imamura
Affiliation:
London School of Hygiene and Tropical Medicine
Nick Black
Affiliation:
London School of Hygiene and Tropical Medicine
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Abstract

Two retrospective cohorts of patients who had undergone a primary total hip replacement (THR) were studied in Japan and England. We analyzed information from hospital case notes and self-administered questionnaires. THR was highly effective in both countries, with significant improvements in morbidity and health status. There were, however, important differences in clinical management and outcome. Japanese patients were more likely to be treated under regional anesthesia by means of an anterior/anterolateral incision, to be transfused, to have a prosthesis implanted without cement, and to stay longer in the hospital. A higher rate of serious in-hospital complications occurred in England, mostly due to the high frequency of hypotension. The incidences of minor complications were consistent with known differences in risks between the two countries. The persistent postoperative perception of limping reported by the English patients was unexpected.

Keywords

Total Hip ReplacementOutcomeClinical Management
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 14 , Issue 4 , Fall 1998 , pp. 762 - 773
Copyright
Copyright © Cambridge University Press 1998

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