Impact of preoperative factors on clinical outcomes after total hip arthroplasty.

Abstract

Background: Although total hip arthroplasty (THA) is an established intervention for advanced hip disorders, not all patients achieve the anticipated functional improvements.

Aim: To investigate the impact of various preoperative factors on clinical outcomes after THA.

Methods: Data of 411 patients who underwent unilateral THA were retrospectively analyzed. The associations between preoperative factors, such as age, body mass index, pain severity, functional impairment, psychological status, neuropathic pain, and central sensitization, and clinical outcomes assessed six months postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and modified Harris Hip Score were evaluated.

Results: Our results indicated that age and the WOMAC, Center for Epidemiologic Studies Depression Scale, and Central Sensitization Index (CSI) scores significantly predicted the modified Harris Hip Score outcomes, whereas age and preoperative WOMAC, EuroQol 5 dimensions, Center for Epidemiologic Studies Depression Scale, CSI, and Pain Detect Questionnaire scores were significant predictors of WOMAC outcomes. Age, WOMAC, and CSI were consistently significant factors. There were no significant differences in the operative time or blood loss across the outcome categories.

Conclusion: Our findings highlight the importance of preoperative assessment of central sensitization and psychological parameters. Patient-specific preoperative characteristics may play a greater role than intraoperative factors in determining recovery outcomes after THA.