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Problem
Add Kaplan–Meier time-to-re-operation analysis with log-rank test as the primary statistical approach for the main endpoint.
Time-to-event analysis is the standard for surgical failure endpoints in arthroplasty literature; chi-squared on proportions ignores timing and follow-up variability.
Suggested fix
Add Kaplan–Meier time-to-re-operation analysis with log-rank test as the primary statistical approach for the main endpoint.
Problem
Report post-hoc power calculation; explicitly frame the study as hypothesis-generating and underpowered if confirmed; propose a multicentre registry extension.
A 'no significant difference' finding in a study of 64 patients does not constitute equivalence evidence; clearly quantifying power prevents misleading clinical interpretation.
Suggested fix
Report post-hoc power calculation; explicitly frame the study as hypothesis-generating and underpowered if confirmed; propose a multicentre registry extension.
Problem
Add Oxford Hip Score or EQ-5D as a supplementary PROM alongside Harris Hip Score; compare against national registry benchmarks.
HHS ceiling effects in THA populations limit sensitivity to functional differences; PROMS aligning with registry data enable external benchmarking.
Suggested fix
Add Oxford Hip Score or EQ-5D as a supplementary PROM alongside Harris Hip Score; compare against national registry benchmarks.
Quick win: The decade of consecutive PFF data is a genuine strength. The main revision priorities are statistical: add Kaplan–Meier survival curves for re-operation, report power calculations, and explicitly acknowledge the underpowering for the primary endpoint. These additions are achievable without new data collection and would substantially improve the manuscript.
