Impact of Comorbidities on Outcome After Total Hip Arthroplasty

Background: Patient-reported outcome scores gain increasing importance in quantifying clinical success and procedure remuneration. Our aim was to valuate the impact of comorbidity on joint-specific outcome and general health in patients undergoing elective total hip arthroplasty (THA).

Methods: Longitudinal data on THA procedures were used to evaluate the association between comorbidity and surgical outcome in terms of joint-specific measures and general health (Forgotten Joint Score-12 [FJS-12], Oxford Hip Score [OHS], and Short Form-12) at 1-year follow-up. Comorbidities comprised the Charlson comorbidity index (CCI), low back pain (LBP), pain from other joints (POJ), and body mass index.

Results: We analyzed data from 251 THA patients (age: 67.7 ± 11.8 years; 58.2% female). Most common conditions were POJ (75.9%), LBP (55.1%), connective tissue disease (12.1%), and diabetes (5.6%). With regard to postoperative improvement, we did not find statistically significant differences between patients with or without CCI comorbidities (FJS-12, þ38.7 vs þ43.2, P ¼.370; OHS, þ15.6 vs þ17.9, P ¼.100) or POJ (FJS-12, þ39.9 vs þ45.1, P ¼ .325; OHS, þ17.3 vs þ16.6, P ¼ .645). Patients with LBP showed less improvement on the FJS-12 than those without LBP (þ35.6 vs þ49.1; P ¼ .002), whereas no difference was found for the OHS (þ17.9 vs þ16.5; P ¼ .266).

Conclusion: Patients with comorbid conditions report lower preoperative and postoperative outcome scores compared with patients with no such conditions; however, there was no statistically significant association of CCI comorbidities and POJ with postoperative improvement in joint-specific outcomes. LBP was found to have a negative impact on postoperative improvement in terms of joint awareness.