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Long-Term Results of Total Hip Replacement Surgery

Posted on: 11/30/1999
Total hip replacements (THRs) work well to reduce pain and improve function for almost all patients having this surgery. So say researchers in Switzerland. They conducted a large study of more than 25,000 THRs. In this study, the results of first-time THRs are reported. Factors such as age, gender, and body weight are also measured. The effects of these patient-related factors on the final outcome are summarized.

Patients were followed for up to 15 years. Activities were measured, such as getting up from a chair, stair climbing, and walking. X-rays were reviewed. The patients' opinions about the results were graded as excellent, good, fair and poor. Patients were asked to rate their satisfaction based on symptoms, limits, and need for drugs.

The authors report that more than 93 percent of the patients said their results were "excellent" or "good" for the first five years. After that, patient satisfaction declined slowly. In later follow-ups, between 85 and 90 percent of patients were still satisfied with their THRs. This figure dropped to 70 percent at 15 years.

The researchers also found the greatest improvement in pain and function during the first two years after THA. For some patients walking capacity continues to improve for as many as five years after THA. Later declines in walking and function may be caused by aggravation of symptoms in the other (as yet unreplaced) hip.

Male patients seem to get better function than females. Doctors think this may be because women have more THRs for rheumatoid arthritis and hip fractures. These two diagnoses are known to have poorer results after THR than for osteoarthritis. Obese patients and patients older than 70 years have the poorest results.

The authors conclude THR is very effective and reliable. Most patients see gains for up to five years. Even after the first five years, THR is a durable option, and most patients are very satisfied with the results.

Christoph Röder, MD, et al. Demographic Factors Affecting Long-Term Outcome of Total Hip Arthroplasty. In Clinical Orthopaedics and Related Research. December 2003. Vol. 417. Pp. 62-73.

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