Physical functioning and health-related quality of life: before and after total hip replacement

Total hip replacement (THR) is a commonly adopted procedure for arthritis-related diseases. Although the THR efficacy in pain relief and restoration of physical functioning has been extensively studied, it remains unclear how health-related quality of life is affected by THR. The major purpose of this study was to examine and compare the differences in physical functioning and health-related quality of life for THR patients before and after operations. Based on a prospective study design, 46 THR patients at one medical center were reviewed and followed up (six months after operations) during the period from March 1997 to June 1998, with a follow-up rate of 88%. The THR subjects were interviewed and measured by the Modified Harris Hip Scale and the Chinese-version Short-form 36-item Health Survey (SF-36). Patient characteristics and the information related to procedures were derived from chart review. The results indicated that the THR patients had statistically significant improvements in physical functioning and health-related quality of life. In terms of the Harris Score, the mean Harris score was 91.6 (SD = 10.7) 6 months after THR, as compared to 45.2 (SD = 17.3) before THR. The eight ratings in the SF-36 measures were also statistically significantly improved (p < 0.001). Specifically, "role limitations due to physical functioning" demonstrated dramatic improvements after THR (15.2 vs. 63.5), followed by "role limitations due to emotional problems" (25.4 vs. 85.5). The findings confirm the effectiveness of THR outcomes in terms of physical functioning, pain relief, and health-related quality of life, which can be revealed by disease-specific (Harris Scale) and generic health measures (SF-36).