Adult Reconstruction & Joint Replacement Division, Department of Orthopaedic Surgery, Investigation performed at Hospital for Special Surgery, New York, NY.
J Arthroplasty. 2021 Aug;36(8):2850-2857. doi: 10.1016/j.arth.2021.03.052. Epub 2021 Apr 3.
Total hip arthroplasty (THA) patients expect pain relief and functional improvement, including return to physical activity. Our objective was to determine the impact of patients' physical activity level on preoperative expectations and postoperative satisfaction and clinical outcomes in patients undergoing THA.
Using an institutional registry of patients undergoing THA between 2007 and 2012, we retrospectively identified patients who underwent unilateral primary THA for osteoarthritis and completed a preoperative Lower Extremity Activity Scale, Hospital for Special Surgery Hip Replacement Expectations Survey, and Hip disability and Osteoarthritis Outcome Score in addition to two-year HOOS and satisfaction evaluations. Active patients (n = 1053) were matched to inactive patients (n = 1053) by age, sex, body mass index, and comorbidities. The cohorts were compared with regard to the association of expectations with Hip disability and Osteoarthritis Outcome Score and satisfaction, the change in Lower Extremity Activity Scale level from baseline to 2 years, complications, and revision surgical procedures.
Significantly more active patients (74%) expected to be "back to normal" regarding ability to exercise and participate in sports compared with inactive patients (64%, P < .001). Overall satisfaction was similar. Higher expectations with regard to exercise and sports were associated with higher HOOS sports and recreation subdomain scores in active patients. The inactive patient group improved on baseline activity level at 2 years while the active group did not.
At 2 years after THA, active and inactive patients were similarly satisfied and achieved comparable outcomes. Inactive patients showed a greater improvement in physical activity level from preoperative baseline than active patients. Complications and revision rates were similar.
III.
全髋关节置换术（THA）患者期望缓解疼痛并改善功能，包括恢复身体活动。我们的目的是确定患者的身体活动水平对接受 THA 的患者术前期望、术后满意度和临床结果的影响。
使用 2007 年至 2012 年间接受 THA 的机构登记处，我们回顾性地确定了接受单侧初次 THA 治疗骨关节炎且完成术前下肢活动量表、特殊外科医院髋关节置换期望调查、髋关节残疾和骨关节炎结局评分的患者，此外还进行了为期两年的 HOOS 和满意度评估。活跃患者（n=1053）按年龄、性别、体重指数和合并症与不活跃患者（n=1053）进行匹配。比较了两个队列的期望与髋关节残疾和骨关节炎结局评分以及满意度的关系，从基线到 2 年的下肢活动量表水平变化，并发症和翻修手术。
与不活跃患者（64%，P<0.001）相比，更多的活跃患者（74%）期望在锻炼和参加运动方面“恢复正常”。总体满意度相似。与运动和运动相关的更高期望与活跃患者的 HOOS 运动和娱乐子域评分较高相关。不活跃患者组在 2 年时基线活动水平有所提高，而活跃患者组则没有。
THA 后 2 年，活跃和不活跃患者的满意度相似，且结果相当。不活跃患者的身体活动水平从术前基线到术后的改善程度大于活跃患者。并发症和翻修率相似。
III。
