Patient relevant outcome 7 years after total hip replacement for OA - a prospective study

Abstract

Background: To investigate prospectively the patient-relevant outcome 7 years after total hip replacement (THR) for osteoarthritis (OA).

Methods: 219 consecutive patients (120 women) with primary OA, mean age 71 (range 50-92) were assigned for THR. They were examined preoperatively, at 3, 6, 12 months, and at 4, 5 and 7 years postoperatively with the self-administered questionnaires SF-36 and WOMAC. Supplementary questions regarding postoperative complications, general co-morbidity, social circumstances and patient satisfaction were asked at the three last follow-ups. A reference group, 117 subjects (67 women), mean age 72 (range 52-92) without hip complaints were recruited from the community and investigated at the same times.

Results: 151/170 (89%) of the patients and 65/74 (88%) of the reference group participated at the 7 year follow-up. The best postoperative result was reported one year postoperatively. At the 7 year follow up there was a significant difference between the patients and controls in SF-36 physical function (PF) and role physical (RP) but not of WOMAC function. There was no difference in frequency of co-morbid conditions between those operated and the reference group, but those operated were in greater need of walking aid (46% vs. 8% p < 0.0001) and reported more regional and widespread pain (68% vs. 53% p < 0.05).

Conclusion: This study shows that in an unselected cohort the patients experience a similar health-related quality of life as a reference group of a similar age and sex structure 7 years after THR except for general physical function where the patients score worse.

Figure 1

SF-36 pain scores before and after THR. The mean SF-36 pain scores at the preoperative, 12 months, 4 year, 5 year and 7 years follow-up according to preoperative SF-36 quartiles.

Figure 2

SF-36 PF scores before and after TKR. The mean SF-36 PF scores at the preoperative, 12 months, 4 year, 5 year and 7 years follow-up according to preoperative SF-36 quartiles.