Quality of life and hip functionality 11 to 23 years after total hip arthroplasty

We conducted a retrospective follow-up study to evaluate the quality of life and functionality of 250 patients (330 procedures) an average of 16 years (range: 11-23 years) after total hip arthroplasty using a validated assessment set, including the official Italian version of the Short Form-36 Health Survey (SF-36) Questionnaire, the Harris Hip Score (HHS), the Italian version of the Western Ontario and Mac Master University (WOMAC) Questionnaire, and a study-specific questionnaire dealing with patients’ degree of satisfaction with surgery. At the present follow-up control, the SF-36 physical indexes of these patients compared negatively with the age- and sexmatched normative values. Subjects from the study group also obtained lower Harris hip score and poorer WOMAC scores in comparison with age-matched normative data, but there was a 96% rate of post-surgical satisfaction. Forty-one THA in 36 patients were revised (reoperation rate = 12.4 %). Hip functionality and comorbidities were the most important determinants of physical measures on the SF-36. During our multivariate analysis, neither the bilaterality of the procedure, use of cemented or cementless implant, nor possible reoperations was found to be related to the SF-36 or WOMAC scores and HHS. In conclusion, patients who had undergone total hip replacement have impaired long-term self-reported physical quality of life and hip functionality, however the level of post-surgical satisfaction is high.