Predictors of health-related quality-of-life change after total hip arthroplasty

Clin Orthop Relat Res. 2009 Nov;467(11):2886-94. doi: 10.1007/s11999-009-0868-9. Epub 2009 May 2.


Various parameters have been considered as possible predictors of health-related quality-of-life outcomes after THA in patients with hip osteoarthritis. We hypothesized the preintervention health status is the main and more homogeneous predictor of changes of the different aspects of health-related quality-of-life outcomes, mental health status has an important influence on results, whereas other sociodemographic or clinical factors had only a punctual influence. All patients who fulfilled the selection criteria completed the Medical Outcomes Study SF-36 and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 6 months after the intervention. Seven hundred eighty-eight patients completed the questionnaire before the intervention and 590 completed it (74.9%) at 6 months. The preintervention score in each SF-36 and WOMAC domain and the SF-36 mental health domain predicted changes after the intervention. Female gender, having comorbidities, contralateral hip osteoarthritis, or back pain predicted less improvement on some SF-36 domains. Older age, the presence of contralateral hip osteoarthritis, or back pain predicted less improvement on some of the WOMAC domains. Preintervention health status, measured by the WOMAC or SF-36, and mental health status uniformly predicted health-related quality-of-life changes, whereas some clinical parameters predicted some domains. SF-36 and WOMAC seem to be appropriate tools for predicting THA outcomes.

Level of evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological
  • Adaptation, Psychological
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Hip / psychology*
  • Cohort Studies
  • Female
  • Hip Prosthesis*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / diagnosis
  • Osteoarthritis, Hip / surgery*
  • Pain Measurement
  • Patient Satisfaction / statistics & numerical data*
  • Postoperative Care / methods
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Probability
  • Quality of Life*
  • Severity of Illness Index
  • Sex Factors
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Treatment Outcome