Impact of Comorbidities on Outcome After Total Hip Arthroplasty

J Arthroplasty. 2017 Sep;32(9):2755-2761. doi: 10.1016/j.arth.2017.04.013. Epub 2017 Apr 19.


Background: Patient-reported outcome scores gain increasing importance in quantifying clinical success and procedure remuneration. Our aim was to evaluate 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, +38.7 vs +43.2, P = .370; OHS, +15.6 vs +17.9, P = .100) or POJ (FJS-12, +39.9 vs +45.1, P = .325; OHS, +17.3 vs +16.6, P = .645). Patients with LBP showed less improvement on the FJS-12 than those without LBP (+35.6 vs +49.1; P = .002), whereas no difference was found for the OHS (+17.9 vs +16.5; P = .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.

Keywords: Forgotten Joint Score-12; Oxford hip score; arthroplasty; comorbidity; outcome.

MeSH terms

  • Adult
  • Aged
  • Arthralgia / etiology
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Comorbidity*
  • Female
  • Humans
  • Low Back Pain / etiology
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Postoperative Period
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome