University of Geneva and Geneva University Hospitals, Geneva, Switzerland.
Arthritis Care Res (Hoboken). 2014 Feb;66(2):277-84. doi: 10.1002/acr.22101.
Detailed assessment of activity before and after total hip arthroplasty (THA) including a long-term followup period is lacking. Our objectives were to evaluate patient activity levels prior to disease onset, prior to THA, and at 5 and 10 years after surgery, and to determine the predictors of high activity 5 years after surgery.
We included elective primary THAs performed between 1996 and 2012. A cross-sectional analysis compared mean University of California, Los Angeles (UCLA) activity scores over 4 periods: prior to symptom onset of osteoarthritis, prior to surgery, 5 years after surgery, and 10 years after surgery. Analyses of activity levels were performed and stratified by sex, age, body mass index (BMI), American Society of Anesthesiology (ASA) classes, and preoperative activity level. A prospective study was conducted to identify baseline characteristics associated with a high activity level (UCLA score ≥7) 5 years after surgery using logistic regression.
The mean UCLA activity scores prior to symptom onset (n = 189), prior to THA (n = 203), 5 years after surgery (n = 1,085), and 10 years after surgery (n = 757) were 6.9, 3.5, 5.7, and 5.5, respectively. Postoperative scores were close to values prior to symptom onset in patients ages ≥55 years, but were lower in those who were younger. High activity was reported by 49% of patients prior to symptom onset, 5% of patients prior to surgery, and 28% of patients at both 5 and 10 years after surgery. The predictors of high activity at 5 years were younger age, male sex, a lower BMI, a lower ASA score, and an active lifestyle prior to surgery.
Five and 10 years after primary THA, physical activity levels were substantially higher in men and women and in all age categories as compared to before surgery.
全髋关节置换术（THA）前后活动的详细评估，包括长期随访期，目前还缺乏这方面的研究。我们的目标是评估患者在疾病发作前、THA 术前以及术后 5 年和 10 年的活动水平，并确定术后 5 年高活动水平的预测因素。
我们纳入了 1996 年至 2012 年期间进行的择期初次 THA。通过横向分析比较了 4 个时期的加利福尼亚大学洛杉矶分校（UCLA）活动评分的平均值：关节炎症状发作前、手术前、手术后 5 年和手术后 10 年。对活动水平进行了分析，并按性别、年龄、体重指数（BMI）、美国麻醉医师协会（ASA）分级和术前活动水平进行了分层。前瞻性研究旨在使用逻辑回归确定与术后 5 年高活动水平（UCLA 评分≥7）相关的基线特征。
在关节炎症状发作前（n=189）、THA 术前（n=203）、术后 5 年（n=1085）和术后 10 年（n=757）时，UCLA 活动评分的平均值分别为 6.9、3.5、5.7 和 5.5。对于年龄≥55 岁的患者，术后评分接近症状发作前的值，但对于年龄较小的患者，评分较低。在症状发作前，有 49%的患者报告了高活动水平，在手术前，有 5%的患者报告了高活动水平，在术后 5 年和 10 年时，有 28%的患者报告了高活动水平。术后 5 年高活动水平的预测因素为年龄较小、男性、BMI 较低、ASA 评分较低以及手术前的积极生活方式。
与手术前相比，初次 THA 后 5 年和 10 年，男性和女性以及所有年龄组的身体活动水平都有了显著提高。
