Short-term patient-reported outcomes following total hip replacement: Is the success picture overrated?

OBJECTIVES: Our objective was report short-term results of total hip replacement (THR) and to identify patients with functional recovery and with treatment failure. We also aimed to investigate whether there are any potential predicting factors for functional recovery or treatment failure. DESIGN: Prospective cohort study. Clinical examination was performed and data were collected from patients before THR and at three follow-up assessments within subsequent year. The primary endpoint was the change between assessments in the average score on four subscales of the Hip disability and Osteoarthritis Outcome Score (HOOS(4)) covering pain, symptoms, activity of daily living, and quality of life. Secondary endpoints included results on all five HOOS subscales, and the SF–36. Functional Recovery and Treatment Failure were defined basing on the published reference population values. RESULTS: We assessed 179 patients (98 women and 81 men, mean age at THR 67 years, range 31–90 years). The mean HOOS(4) scores continued to improve up to 12 months after THR. Functional Recovery was identified in 32% while Treatment Failure in 16% of the patients. We found an association between high (>30.3) preoperative SF–36 Physical Component Summary scores and Functional Recovery, as well as low preoperative SF–36 Physical (<30.3) and Mental (<35.9) Component Summary scores and Treatment Failure. CONCLUSIONS: Knowing that only one third of subjects undergoing THR achieved Functional Recovery and one sixths had Treatment Failure, gives us a better perspective to discuss feasibility of expectations and, consequently, to prevent patient dissatisfaction following THR.