Abstract
BACKGROUND:
Modern total hip arthroplasty (THA) has shown a great improvement in pain, function and range of motion of patients but data on patients' quality of life after this surgery as assessed by validated tools are lacking.
METHODS:
In this cohort study we evaluated the quality of life and functionality of 250 patients an average of 16 years (11–23) after THA using the SF-36 questionnaire, the Harris Hip Score, the WOMAC score, the Functional Comorbidity Index, and a study specific questionnaire. Models of multiple stepwise linear and logistic regression analysis were constructed to evaluate the relationships between the explanatory variables and the functional outcomes.
RESULTS:
The SF-36 physical indexes of these patients compared negatively with the normative values but positively with the results obtained in untreated subjects with severe hip osteoarthritis. Similar results were detected for the Harris Hip Score and WOMAC score. Patients with unilateral THA scored better than patients with bilateral THA on the RP (p < 0.001), GH (p < 0.05), SF (p < 0.05), and PCS (p < 0.05) SF-36 scales. Better results were obtained by subjects with osteonecrosis compared to those with OA on the PCS (p = 0.022) scale. There was a 96% rate of post-surgical satisfaction. A preoperative diagnosis of hip dysplasia was associated with a lesser degree of postoperative satisfaction and willingness to undergo the surgery again. Hip functionality and comorbidities were the most important determinants of physical measures on the SF-36.
CONCLUSIONS:
Patients treated with THA a mean of 16 years earlier have poorer health related quality of life with respect to age-matched healthy controls. However, their scores on physical SF-36 scales still perform better in comparison with those previously reported in subjects with advanced hip osteoarthritis. The level of post-surgical satisfaction after THA is high.
