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Study Examines Patient Outcomes Of Total Hip Arthroplasty

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Over the past 40 years, total hip replacement, also called total hip arthroplasty (THA), has significantly reduced pain and improved function in patients with severe joint damage caused by rheumatoid arthritis, osteoarthritis or other causes.

Previous research has gathered group-level data comparing results on people who underwent THA and those who did not.

However, a new study looks at individual THA patient outcomes at two and five years, providing a clearer picture on what patients can expect from the surgery.

The study, published in the February issue of the Rheumatology journal, analysed information from the Mayo Clinic Total Joint Registry, which contains data on almost all of the total hip replacements conducted at the clinic over the past 43 years.

The research, led by Dr Jasvinder Singh from the University of Alabama at Birmingham School of Medicine, looked at 6,168 primary total hip replacement patients and 2,063 patients who had revision surgery between 1993 and 2005. The patients, who were on average in their mid-60s, answered questionnaires two and five years after the operation.

The analysis showed more significant improvements in patients having their first surgery as well as in patients with moderate pre-operative pain. Of the latter, 94% reported mild or no pain after two years and 91% reported mild or no pain after five years. Of the patients with severe pre-operative pain, 91% had mild or no pain after two years and 89% reported mild or no pain after five years.

Among the patients having revision surgery with moderate pre-operative pain, 84% had mild or no pain after two years and 80% had mild or no pain after five years.

Focusing on revision THA patients with severe pre-operative pain, 77% reported mild or no pain after two years and 78% had mild or no pain after five years.

The research also looked at activity limitations (ability to walk, climb steps, etc). Of the primary THA patients, 4% with moderate pre-operative limitations and 17% with severe limitations still had those limitations after two years. At five years, the proportion increased to 7% and 20%, meaning that 80% were doing well. Of the revision THA patients, roughly 70% had improved their ability to perform daily tasks, which is quite encouraging, Dr Singh says, adding that the data would hopefully help patients and their doctors make the best treatment decisions by evaluating benefits and risks.

Overall, the study, which examined operations by various surgeons using various kinds of implants, confirms that THA is a very successful procedure.