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[Primary hip replacement: first year results and predictive factors of poor outcome]
C Sarasqueta1, A Escobar, Y Arrieta
1Unidad de Investigación, Hospital Donostia, Donostia, San Sebastián, Guipúzcoa, España. CRISTINA.SARASQUETAEIZAGUIRRE@osakidetza.net
Insights
Total hip arthroplasty significantly improves pain and function in osteoarthritis patients within three months. Pre-surgery physical status and surgical complications predict functional recovery.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Rehabilitation Medicine
Background:
- Osteoarthritis (OA) significantly impacts joint function and quality of life.
- Total hip arthroplasty (THA) is a common treatment for end-stage hip OA.
Purpose of the Study:
- To evaluate THA outcomes in OA patients.
- To identify predictors of poor functional outcome after THA.
Main Methods:
- Prospective observational study of 166 patients undergoing THA in 2006.
- Follow-up for 1 year, assessing pain, function, quality of life (WOMAC, SF-12), complications, and mortality.
- Logistic regression used to identify predictors of poor functional outcome.
Main Results:
- Significant improvements in pain, stiffness, and function (WOMAC) within 3 months post-THA.
- Moderate improvements in SF-12 physical and mental components.
- Pre-surgery WOMAC function, SF-12 physical component, and occurrence of complications predicted poor functional recovery.
Conclusions:
- THA yields substantial early functional improvement in OA patients.
- Pre-operative physical status and post-operative complications are key determinants of THA success.
Objective:
To evaluate the results of total hip arthroplasty in patients with osteoarthritis and to identify predictors of poor functional outcome.
Material And Methods:
A prospective observational study in patients operated on in 2006 with total hip arthroplasty in 4 hospitals in Guipúzcoa, followed up for 1 year.
Outcome Variables:
pain, physical function, complications, mortality, quality of life by WOMAC and SF-12 (at 0, 3, 6 and 12 months) and «Poor functional outcome» at one year (last quartile of the WOMAC in function area). Logistic regression was performed to examine predictors of poor functional outcome.
Results:
A total of 166 patients were followed up. The incidence of systemic and local complications was 6.3% and 14.5%, respectively, 4.3% readmissions and no deaths related to surgery. Close to 40 points improvement in pain, stiffness and WOMAC functional limitation, mainly in the first 3 months after surgery. A similar trend was seen, but lower in the physical and mental component of the SF12 (12 and 8 points, respectively). The previous score on the WOMAC function area and the physical component of SF-12, and the existence of any complications, are predictors of poor functional recovery.
Discussion:
The improvement experienced after the surgery is already very important before the third month. The functional and physical status before surgery and possible complications of surgery are significant determinants of the results.
