Does Activity Level After Primary Total Hip Arthroplasty Affect Aseptic Survival?

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Rehabilitation Medicine

Background:

• Total hip arthroplasty (THA) aims to restore function and reduce pain.
• Assessing the impact of patient activity levels on THA outcomes is crucial for patient guidance.

Purpose of the Study:

• To compare survivorship and functional outcomes between high-activity and low-activity patients following primary THA.

Main Methods:

• Retrospective review of 2532 primary THAs using vitamin E-infused crosslinked polyethylene liners.
• Patients categorized into low activity (UCLA ≤5) and high activity (UCLA ≥6) groups.
• Analysis of Harris Hip Score, UCLA activity score, reoperations, and survivorship using multivariate regression.

Main Results:

• High-activity patients demonstrated significantly greater improvements in Harris Hip Score and UCLA activity scores.
• Aseptic revisions were significantly lower in the high-activity group (0.4%) compared to the low-activity group (2.1%).
• Higher postoperative activity was a significant predictor of improved aseptic survivorship (OR 4.9, P=.03), with 5-year all-cause survivorship at 99% (HA) vs 96% (LA).

Conclusions:

• Elevated activity levels post-primary THA are not detrimental to implant survivorship at short to midterm follow-up.
• Modern THA implants, including vitamin E-infused liners, support high functional demands.
• Encouraging appropriate activity levels may enhance functional recovery and long-term outcomes in THA patients.