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Functional Outcomes Five to 20 Years After Total Hip Arthroplasty in Patients Under Age of 40 Years: A Comparative
Sibel Bozgeyik-Bagdatli1, Ezgi Çelebi1, Ömür Çağlar2
1Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Türkiye.
Background:
Total hip arthroplasty (THA), originally developed for elderly patients who have advanced hip osteoarthritis, is increasingly performed in younger adults. Despite advances in implant technology and surgical technique, functional outcomes five to 20 years after arthroplasty in this population remain limited. This study aimed to compare, at five to 20 years, functional performance, hip-related outcomes, and health-related quality of life between individuals who underwent THA before the age of 40 years and asymptomatic age-matched controls.
Methods:
A prospective cohort study was conducted including 48 patients who had undergone THA (mean postoperative duration: 10 years) and 48 healthy controls. Functional performance was assessed using the Timed Up and Go and Five-Time Sit-to-Stand tests. Hip-related outcomes (Harris Hip Score and Oxford Hip Score) and quality of life (short form-12) were evaluated.
Results:
Patients in the THA group showed significantly poorer functional performance in both Timed Up and Go and Five-Time Sit-to-Stand tests compared with controls (P < 0.001). Hip function scores (Harris Hip Score, Oxford Hip Score) and short form-12 physical component scores were also lower (P < 0.001), while mental component scores did not differ (P = 0.459). Fear-related perceptions-particularly fear of prosthesis damage and reoperation-were relatively higher among patients in the THA group.
Conclusions:
Although pain relief and subjective hip function remain satisfactory many years after arthroplasty, younger adults who underwent THA demonstrate persistent deficits in mobility and physical quality of life. Targeted rehabilitation strategies addressing both physical and psychological factors are essential to optimize long-term recovery in young THA patients.
