Authors: Singh, Manjot BS; McAnena, Aidan P. BS; Harary, Joyce BS; Schilling, Peter L. MD; Moschetti, Wayne E. MD
From the Warren Alpert Medical School of Brown University, Brown University, Providence, RI (Singh), the UMass Chan Medical School, University of Massachusetts, Worcester, MA (McAnena), Force Therapeutics, New York, NY (Harary), and the Dartmouth Hitchcock Medical Center, Department of Orthopaedics, Lebanon, NH (Schilling and Moschetti).
Abstract
Background
Total hip arthroplasty (THA) is frequently performed in patients with severe hip osteoarthritis to reduce pain and restore function. Although dissatisfaction following total knee arthroplasty is commonly reported at around 20%, satisfaction after THA is less well studied.
Methods
This retrospective review included THA patients who used a web-based home therapy program (force therapeutics) between November 2018 and December 2023. Patients were stratified by 12-week postoperative satisfaction. Univariate analyses were performed on demographics and functional outcomes. Stepwise logistic regression analyses were performed to identify parameters predictive of satisfaction following THA.
Results:
Among 1,414 included patients, 1,335 (94.4%) reported satisfaction following THA. Satisfied patients had lower mean age (satisfied = 67.9 vs. not satisfied = 71.5 years, P < 0.001) as well as higher body mass index (30.2 vs. 28.3 kg/m2, P = 0.035) and medical comorbidities (71.4% vs. 60.8%, P = 0.044). Across the cohort, patient-reported outcome measures improved significantly from preoperatively to 1-year postoperatively (P < 0.05). Preoperatively, satisfied patients reported higher preoperative patient-reported outcomes measurement information system (PROMIS) Overall, Physical, and Mental scores (P < 0.05). One-year postoperatively, satisfied patients noted larger improvements in functional outcomes, yielding better PROMIS Overall (39.3 vs. 32.8), Physical (52.0 vs. 43.5), and Mental (53.5 vs. 47.2), hip disability and osteoarthritis outcome score joint replacement (HOOS Jr; 87.8 vs. 71.9), and visual analog scale pain (2.1 vs. 3.9) scores (all P < 0.001). Stepwise regression analyses revealed that age (odds ratio = 0.96, 95% confidence interval = 0.92 to 1.00, P = 0.033) and PROMIS Mental scores (odds ratio = 1.05, 95% confidence interval = 1.00 to 1.09, P = 0.040) were predictive of satisfaction after THA.
Conclusion
In a modern cohort of THA patients, nearly 95% reported satisfaction following surgery. Satisfied patients had better preoperative and postoperative functional outcomes. Lower age and better mental health may possibly predict postoperative satisfaction. Although careful preoperative selection of patients should still be employed, patient satisfaction following THA is high.