Activity Levels and Functional Outcomes of Young Patients Undergoing Total Hip Arthroplasty

Abstract

The activity demands of young patients undergoing total hip arthroplasty (THA) have not been clearly defined. University of California Los Angeles (UCLA) activity score, Hip disability and Osteoarthritis Outcome Score (HOOS), Short Form-12 version 2 (SF-12v2), and Functional Comorbidity Index (FCI) questionnaires were administered to 70 young patients who had undergone THA (young THA group; ie, ≤30 years old), 158 general patients who had undergone THA (general THA group; ie, ≥31 years old), and 106 young, comorbidity-matched patients who had not undergone arthroplasty and had no significant hip disease (nonarthroplasty group). Mean postoperative UCLA activity scores were similar among groups (young THA group, 6.5; general THA group, 6.4; nonarthroplasty group, 6.6) before and after adjustment for comorbidity, sex, and race (P=.62 and P=.47, respectively). Adjusted analyses also found a negative association between postoperative activity and increases in comorbidity and female sex (P<.001). Patients in the young THA group reported higher expectations of postoperative activity (7.7) than those in the general THA group (7.1; P=.02). Postoperative HOOS results showed greater hip symptoms (P=.003) and poorer hip-related quality of life (P<.001) in the young THA group. Patient groups had similar postoperative SF-12v2 physical health scores (P=.31), although mental health scores were significantly higher in the general THA group (P<.001). The interesting finding of lower postoperative expectations, greater hip-related quality of life, and better mental health scores in the general THA group may indicate a need for better management of expectations in young patients undergoing THA, including a discussion of realistic gains in activity and potential comorbidity-related restrictions.

Hip complaints differ across age and sex: a population-based reference data for the Hip disability and Osteoarthritis Outcome Score (HOOS)

“…The HOOS was constructed to better fit, as compared to the WOMAC, patients’ expectations of more demanding physical function – for example for younger individuals and individuals in an early stage of the disease [ 5 ]. The HOOS has been recommended specifically for the evaluation of patients with hip OA undergoing non-surgical or surgical interventions such as total hip replacement (THR) [ 2 , 6 , 7 ]. When assessing individuals with hip OA the psychometric properties of the HOOS have shown adequate test-retest reliability, floor and ceiling effects, and construct validity.…”

Outcomes of Unilateral Total Hip Arthroplasty in Patients Aged Under 35 Years in Iranian Population: A Preliminary Study

“…Joint ROM is the most important factor for quality of life after knee or hip replacement. [ 20 ] In younger patients, the role of activity as a marker of quality of life is becoming increasingly apparent. [ 20 21 ] HHS is a useful and variable system to assess hip joint function.…”

Das Laufverhalten von Patienten mit künstlichem Hüftgelenkersatz und dessen Folgeerscheinungen: Ein systematisches Review zum aktuellen Forschungsstand

“…Speziell die immer größer werdende Gruppe der Hüftpatienten bis 30 Jahre erfordert ein Umdenken im Bereich Sport und Prothese. Die Rückkehr zu hochintensiven Sportarten steht gerade bei den jüngeren Patienten auf der Wunschliste (8).…”

“…Viele Patienten kehren nach der Operation zum Laufsport zurück (7). Gerade die jungen Hüftpatienten unter 30 Jahren haben sehr hohe Ansprüche auf eine intensive Sportausübung nach der Operation (8).…”