Recovery Curves for Patient Reported Outcomes and Physical Function After Total Hip Arthroplasty.

Area of Science:

• Orthopedic surgery
• Rehabilitation medicine
• Patient outcomes research

Background:

• Patient-reported outcome measures (PROMs) are crucial for assessing satisfaction and function after total hip arthroplasty (THA).
• Understanding recovery trajectories can help manage patient expectations during the perioperative period.

Purpose of the Study:

• To define the recovery and functional trajectory in the first year following THA.
• To establish benchmarks for patient recovery after hip replacement surgery.

Main Methods:

• Prospective analysis of 1,898 patients from a multicenter study.
• Utilized Hip disability and Osteoarthritis Score for Joint Replacement and EuroQol-5 dimension PROMs.
• Incorporated wearable technology for physical activity tracking (steps, stairs, gait speed, asymmetry) at multiple postoperative time points.
• Employed generalized estimating equations to analyze longitudinal outcomes.

Main Results:

• All PROMs demonstrated significant improvement from preoperative to postoperative states.
• Greatest PROMs recovery occurred within the first month, exceeding a minimal clinically important difference (MCID).
• Physical function measures like daily steps and flights of stairs required 3 months and 1 year, respectively, to reach MCID.
• Gait speed and walking asymmetry normalized by 3 months but did not achieve MCID within the first year.

Conclusions:

• Patients experience the most substantial PROMs improvement within one month after THA.
• Functional recovery, measured by steps and stairs, surpasses preoperative levels by 3 months.
• Gait quality improvements may extend beyond one year post-THA, necessitating realistic patient counseling.
• These findings aid in setting expectations and identifying patients needing targeted interventions.