Hospital for Special Surgery Hip Arthroplasty Cohort

Total joint replacements are some of the most successful medical devices developed over the
last fifty years. They enable millions of people to remain ambulatory and pain free, with
minimal risk. In 2002, over 200,000 total hip replacements, 350,000 total knee replacements,
and 25,000 total or partial shoulder replacements were performed in the United States (HCUP
data). Future use will likely be even higher: it is estimated that by the year 2020, the
population 65 and over in developed countries will increase by 71%. Existing studies do not
provide adequate prospective data to evaluate long-term outcomes. Most health related quality
of life studies in THA and TKA only report data up to twelve months post-operatively. In
addition, most large studies of TKA and THA have been performed in Medicare patients. While
these databases are important in providing population based data, Medicare studies do not
permit any direct patient contact, and provide no information on patients under 65.

Existing studies have also investigated predictors of patient outcome at one and two years
after joint arthroplasty. However, very little is known about predictors of prosthesis
failure, and there are no validated clinical indicators for choosing one prosthesis model
over another. Once a device is FDA approved, there is very little motivation on the part of
the developer to perform complete post-marketing research, despite the importance of these
data to the public health. Most existent studies are not powered to compare differences
between models.

The purpose of this study is to establish a prospective cohort of HSS total hip arthroplasty.