Minimum 10-year postoperative health-related quality of life and hip function in patients with total hip arthroplasty

Background In most previous publications surgeon-oriented criteria were used to evaluate total hip replacement (THR) results, whereas there is a paucity of data on patient-oriented assessment of the very long-term outcome of this procedure. Materials and Methods We conducted this retrospective, multi-centric, follow-up cohort study to evaluate the minimum 10-year outcome of THR by validated instruments. A total of 486 patients fulfilling the following inclusion criteria underwent THR in two university hospitals in the 1983–1996 period: 1) age at operation = 70 years; 2) primary THR performed for elective or traumatic disease; and 3) use of cemented or cementless components. Exclusion criteria were 1) patients older than 70 years at operation; 2) revision hip arthroplasty; and 3) hip hemiarthroplasty. The patient-oriented assessment included: an SF-36 questionnaire, WOMAC, Functional Comorbidity Index, Harris Hip Score, and a study-specific questionnaire. The results were statistically analysed and compared with normative data or results of previously published series. Relationships between explanatory variables and outcomes of interest were also checked by multiple regression analysis. Results The three WOMAC subscales and the SF-36 subscales showed significant improvements on follow-up. SF-36 scores were similar to age- and sex-matched norms. The WOMAC score was higher than 80/100 in 90% of non revised patients. 85% of patients were satisfied with the outcome of their surgery. Significant inverse association was found between comorbidities and subjective outcomes on multivariate analysis. Discussion Both the SF-36 and the WOMAC scores of patients approximated the normative values or were remarkably similar to the postoperative data obtained using the same instruments in other studies that had much earlier follow-up dates. Conclusions Patients who had undergone THR a minimum of 10 years earlier have a satisfactory self-reported health-related quality of life and good function of the operated hip