Long-term improvement seen with hip replacement

Nov 29, 2007

Total hip arthroplasty (THA), or hip replacement, is an effective treatment for osteoarthritis (OA), but most studies have only followed patients for up to one year. A new study published in the December issue of Arthritis Care & Research examined patients after an average of eight years following hip replacement and found a long-term positive impact on their physical functioning.

Led by Professor Cyrus Cooper and Ms. Janet Cushnaghan of the University of Southampton in Southampton, UK, the study included 282 patients from two English health districts who had OA and were placed on the waiting list for a hip replacement between 1993 and 1995. It also included 295 matched controls from the general population.

At the start of the study patients were interviewed about hip injury, pain, physical function, vitality and mental health. In addition, their BMI was calculated, their hands were examined for Heberden’s nodes, an indication of OA, and their hip X-rays were evaluated for severity of OA. Between 2001 and 2004, they completed a self-administered questionnaire asking if and when they had undergone hip replacement, as well as questions about their physical function, vitality and mental health. Follow-up of the patients took place an average of eight years following hip replacement.

The results showed that patients who were waiting for a hip replacement had markedly worse physical functioning than the controls but only small differences in vitality and mental health at the start of the study. By the time of the follow-up, the physical functioning of the OA patients had improved (while that of the controls had deteriorated) but their vitality had deteriorated. In addition, better physical functioning at the start of the study was associated with a greater decline at follow-up, but higher BMI seemed to have no impact. Those with more severe OA according to their X-rays showed the most improvement in physical functioning.

“Our findings are consistent with a sustained beneficial impact on physical functioning following THA for OA, but we found no evidence for parallel improvement in vitality or mental health,” Professor Cooper stated. The researchers noted that the study is limited because it was an observational investigation as opposed to a randomized controlled trial and information about the patients’ disease and surgical procedures was limited. But this weakness was offset by the fact that the study had a long follow-up interval and a relatively large number of patients and controls. “Even when allowance is made for possible confounding effects, the long-term improvement in the physical functioning of the cases is striking when set against the decline that occurred in controls,” the authors note, suggesting that the benefits of hip replacement are substantial and long-lasting.

Although some previous studies have suggested that hip replacement benefits mental health as well, the current study did not find this to be the case, possibly because the mental health status of the patients at the beginning of the study was no different from the control group, even though they had greater physical limitations. Regarding the finding that BMI did not affect long-term physical functioning, the authors suggest that surgeons are perhaps careful in selecting obese patients for this procedure, but in any case a BMI in the range of up to 30 should not be a deterrent to hip replacement as long as the patient is healthy enough to undergo surgery.

The authors conclude that the study adds to the accumulating evidence of the long-term benefits of hip replacement, especially in patients with more severe changes seen on X-rays, and that perhaps these patients should be given higher priority for the procedure.

Source: Wiley-Blackwell

Explore further: Cold cash just keeps washing in from ALS challenge

add to favorites email to friend print save as pdf

Related Stories

Wearable robots getting lighter, more portable

May 09, 2013

When Michael Gore stands, it's a triumph of science and engineering. Eleven years ago, Gore was paralyzed from the waist down in a workplace accident, yet he rises from his wheelchair and walks across the ...

Recommended for you

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

Ukraine's former world's tallest man dies

Aug 25, 2014

Ukraine's tallest man, who briefly held the world record but gave it up to live as a recluse, has died due to complications from the condition that saw him never stop growing, local media reported Monday.

User comments : 2

Adjust slider to filter visible comments by rank

Display comments: newest first

islamuslam
1 / 5 (1) Nov 29, 2007
What does "BMI" stand for?
out7x
1 / 5 (1) Nov 30, 2007
body mass index must effect the hip replacement over many years. Hip replacement wears out after about 20 yrs. depending on wear.