Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany

Annet Wijnen; Gesine H Seeber; Günter Dietz; Baukje Dijkstra; Johan S Dekker; Karin M Vermeulen; Geranda E C Slager; Aike Hessel; Djordje Lazovic; Sjoerd K Bulstra; Martin Stevens

doi:10.1186/s12891-023-06654-w

Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany

Annet Wijnen, Gesine H Seeber, Günter Dietz, Baukje Dijkstra, Johan S Dekker, Karin M Vermeulen, Geranda E C Slager, Aike Hessel, Djordje Lazovic, Sjoerd K Bulstra, Martin Stevens^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.

METHODS: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.

RESULTS: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.

CONCLUSIONS: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.

TRIAL REGISTRATION: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).

Original language	English
Article number	525
Number of pages	13
Journal	Bmc Musculoskeletal Disorders
Volume	24
DOIs	https://doi.org/10.1186/s12891-023-06654-w
Publication status	Published - 27-Jun-2023

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Wijnen, A., Seeber, G. H., Dietz, G., Dijkstra, B., Dekker, J. S., Vermeulen, K. M., Slager, G. E. C., Hessel, A., Lazovic, D., Bulstra, S. K., & Stevens, M. (2023). Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany. Bmc Musculoskeletal Disorders, 24, Article 525. https://doi.org/10.1186/s12891-023-06654-w

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title = "Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany",

abstract = "BACKGROUND: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.METHODS: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.RESULTS: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.CONCLUSIONS: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.TRIAL REGISTRATION: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).",

author = "Annet Wijnen and Seeber, {Gesine H} and G{\"u}nter Dietz and Baukje Dijkstra and Dekker, {Johan S} and Vermeulen, {Karin M} and Slager, {Geranda E C} and Aike Hessel and Djordje Lazovic and Bulstra, {Sjoerd K} and Martin Stevens",

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doi = "10.1186/s12891-023-06654-w",

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journal = "Bmc Musculoskeletal Disorders",

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Wijnen, A , Seeber, GH, Dietz, G, Dijkstra, B, Dekker, JS, Vermeulen, KM, Slager, GEC, Hessel, A, Lazovic, D, Bulstra, SK & Stevens, M 2023, 'Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany', Bmc Musculoskeletal Disorders, vol. 24, 525. https://doi.org/10.1186/s12891-023-06654-w

TY - JOUR

T1 - Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty

T2 - a comparison of usual care between the Netherlands and Germany

AU - Wijnen, Annet

AU - Seeber, Gesine H

AU - Dietz, Günter

AU - Dijkstra, Baukje

AU - Dekker, Johan S

AU - Vermeulen, Karin M

AU - Slager, Geranda E C

AU - Hessel, Aike

AU - Lazovic, Djordje

AU - Bulstra, Sjoerd K

AU - Stevens, Martin

PY - 2023/6/27

Y1 - 2023/6/27

N2 - BACKGROUND: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.METHODS: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.RESULTS: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.CONCLUSIONS: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.TRIAL REGISTRATION: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).

AB - BACKGROUND: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.METHODS: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.RESULTS: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.CONCLUSIONS: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.TRIAL REGISTRATION: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).

U2 - 10.1186/s12891-023-06654-w

DO - 10.1186/s12891-023-06654-w

M3 - Article

C2 - 37370054

SN - 1471-2474

VL - 24

JO - Bmc Musculoskeletal Disorders

JF - Bmc Musculoskeletal Disorders

M1 - 525

ER -

Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany

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