Total hip or knee replacement for osteoarthritis: mid- and long-term quality of life

To compare quality of life (QOL) scores 3 and 10 years after total hip arthroplasty (THA) or total knee arthroplasty (TKA) for osteoarthritis with QOL scores in a general population, and to determine factors associated with QOL after surgery.

Data were obtained from 2 multicenter cohorts of patients with THA or TKA: 232 patients were recruited during 2003 (3-year cohort) and 221 patients were recruited during 1994 (10-year cohort). Preoperative data (QOL, radiograph results) and followup data (demographics, comorbidities, pain locations, environmental factors, and QOL) were collected. QOL data for the general population were obtained from a 2003 population-based survey.

A total of 195 and 89 patients for the 3- and 10-year cohorts, respectively, were followed up; the mean age at followup was 73 years. For both of the cohorts, physical functioning and role-physical or role-emotional QOL scores were lower than those for a general population with comparable age. Scores for pain, mental health, and social dimensions were lower than those for the reference population for only the 10-year cohort. For both cohorts, increased number of comorbidities, painful locations other than THA or TKA location, and unfavorable environmental factors were associated with impaired QOL. Low preoperative QOL scores were predictive of impaired QOL at followup for only the 3-year cohort.

THA or TKA can improve QOL, but the benefits may be time limited. Addressing environmental factors and treating comorbidities and pain in locations other than the arthroplasty location could have mid- and long-term effects on the QOL of patients with THA or TKA.