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Primary Total Hip Arthroplasty: Equivalent Outcomes in Low and High Functioning Patients
Mohammad Mesfer Alzahrani1, Karen Smith, Dylan Tanzer
1From the Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada (Dr. Alzahrani, Ms. Smith, and Dr. M. Tanzer), and the Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel (Mr. D. Tanzer).
Patients undergoing total hip arthroplasty (THA) with lower preoperative function achieve similar outcomes to high-function patients. This study challenges the notion that poor preoperative physical function predicts worse results after THA.
Area of Science:
- Orthopedic Surgery
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Preoperative physical function is often considered a predictor of postoperative outcomes in total hip arthroplasty (THA).
- Previous research suggested poorer preoperative function correlates with lower functional recovery after THA.
Purpose of the Study:
- To investigate whether preoperative functional level predicts outcomes in patients undergoing THA.
- To evaluate the impact of modern perioperative protocols and surgical techniques on THA outcomes relative to baseline function.
Main Methods:
- Prospective cohort study of 200 patients undergoing THA.
- Assessment of preoperative and 2-year postoperative health-related quality of life (HRQoL).
- Patients stratified into high and low function groups based on WOMAC physical function scores.
Main Results:
- Both high and low function groups demonstrated significant HRQoL improvements (P < 0.001).
- The low function group experienced a substantially greater improvement in HRQoL.
- No significant difference in final HRQoL outcomes between the high and low function groups was observed.
Conclusions:
- The study contradicts the belief that worse preoperative function leads to poorer outcomes after THA.
- Patients with lower preoperative physical function achieve comparable results to higher-functioning patients following THA.
- Modern surgical and perioperative approaches may mitigate the impact of baseline functional status on THA outcomes.
