Does Preoperative Activity Level Affect Postoperative Outcomes Following Total Hip Arthroplasty?

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Patient Outcomes Research

Background:

• Patients undergoing total hip arthroplasty (THA) often prioritize maintaining active lifestyles.
• Evaluating the impact of preoperative activity levels on patient-reported outcomes is crucial for addressing these concerns.

Purpose of the Study:

• To assess how preoperative activity levels influence patient-reported outcomes and improvement following THA.
• To compare functional outcomes, pain levels, and mental state across different preoperative activity groups.

Main Methods:

• 335 patients (368 hips) undergoing THA were evaluated with a minimum 6-month follow-up.
• Preoperative and postoperative University of California, Los Angeles (UCLA) activity scores and other patient-reported measures were collected.
• Analysis of covariance controlled for confounding factors to compare outcomes between inactive, mild, and active preoperative groups.

Main Results:

• Mildly active and active patients demonstrated better postoperative outcomes than inactive patients across several measures (UCLA, EQVAS, HOS, SF-12 Physical, VAS Pain).
• No significant differences in postoperative outcomes were observed between mildly active and active patient groups.
• Inactive patients showed greater *improvement* in UCLA score, Harris Hip Score, and International Hip Outcome Tool compared to mildly active patients.

Conclusions:

• Inactive patients experience greater outcome improvements after THA, but active patients achieve better absolute outcomes.
• Increasing preoperative activity levels does not lead to incrementally better patient-reported outcomes.
• Pain and mental health improvements are comparable across all preoperative activity levels post-THA.