Analysis of factors influencing patient satisfaction after total hip arthroplasty in a Japanese cohort: the significant effect of postoperative physical activity

Abstract

[Purpose] To determine patient satisfaction after total hip arthroplasty in a Japanese cohort and to identify factors that significantly influence patient satisfaction. [Participants and Methods] This study included 285 patients who underwent primary total hip arthroplasty for osteoarthritis. Postoperative satisfaction, Oxford hip score, short form-12 mental component summary score, and University of California Los Angeles activity score were investigated. Muscle strength and daily step counts were determined using a hand-held dynamometer (μ-Tas F1) and activity monitor (ActivPAL) in 89 and 26 patients, respectively. Factors associated with postoperative satisfaction, Oxford hip score-activities of daily living, and University of California Los Angeles activity score were identified. The relationship between the Oxford hip score-activities of daily living and daily step counts was examined. [Results] Overall, 94.7% of the patients reported satisfaction with total hip arthroplasty. The Oxford hip score-activities of daily living and University of California Los Angeles activity score were significantly associated with patient satisfaction. Younger age and hip abductor strength were significantly associated with a higher Oxford hip score-activities of daily living and University of California Los Angeles activity score. The average daily step count was significantly correlated with the Oxford hip score-activities of daily living. [Conclusion] Self-reported physical activity levels significantly influenced patient satisfaction and were correlated with objective muscle strength and daily step count measurements. These findings can guide total hip arthroplasty patient counseling on the importance of muscle strength and activity levels.

Keywords: Activity monitor; Patient’s satisfaction; Total hip arthroplasty.

Fig. 1.

Schematic representation of the study cohort inclusion process and study design.

Fig. 2.

Postoperative muscle strength measurement in total hip arthroplasty patients. During measurement of hip abductor strength, patients were supine with hip and knee in a neutral position (A). A force sensor (μ-Tas F1) was placed 5 cm proximal to the lateral epicondyle of the femur. During measurement of hip flexor (B) and knee extensor (C) strengths, patients were seated with straps across the waist and thighs.

Fig. 3.

Postoperative activity monitoring in total hip arthroplasty patients. Daily step counts were taken for one week using an accelerometer-based activity monitor (activPAL3). A front view of the thumb-sized monitor placed on the anterior aspect of the mid-thigh using a surgical dressing is shown.

Fig. 4.

Postoperative activity levels in total hip arthroplasty patients. The relationship between postoperative Oxford hip score-activities of daily living and the number of steps per day representing the significant association between self-reported and objectively measured physical activities. Postoperative Oxford hip score-activities of daily living were significantly correlated with the number of steps per day (a), but not with number of standings per day (b).