Residual Symptoms and Function in Young, Active Hip Arthroplasty Patients: Comparable to Normative Controls?

Abstract

Background: Whether patient-reported symptoms and function after total hip and surface replacement arthroplasty in young, active patients compare favorably to those without known hip pathology has not been investigated.

Methods: A retrospective, multicenter study was designed in which 5 centers contributed patients aged <60 years with a presymptomatic University of California at Los Angeles score ≥6 undergoing hip arthroplasty. Data were collected by an independent, third-party survey center that administered a questionnaire assessing patient satisfaction and function. A "control" population with no prior hip interventions or hip pathology limiting their activity, that met the age and activity criteria, was identified for comparison using multivariate regression analyses.

Results: Eight-hundred six hip arthroplasties (682 total hip arthroplasty, 124 surface replacement arthroplasty) and 158 controls were included. A greater percentage of hip arthroplasty patients were male and aged >50 years which was controlled during multivariate regression analyses. Control patients reported the presence of a limp (15%), stiffness (11%), and pain in the hip (8%), but to a lesser degree than hip arthroplasty patients. Control patients were less likely to report pain in the hip (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2-0.7, P = .006), stiffness in the hip (OR = 0.5, 95% CI = 0.3-0.8, P = .02), and a limp (OR = 0.5, 95% CI = 0.3-0.8, P < .001) vs patients undergoing hip arthroplasty.

Conclusion: When interviewed by an independent third party, a substantial portion of control patients did note the presence of hip symptoms, but to a lesser degree than young, active patients undergoing hip arthroplasty.

Keywords: controls; function; surface replacement arthroplasty; symptoms; total hip arthroplasty.