Ability to Perform Daily Activities Preoperatively May Predict the Outcome of THA
A new study from Johns Hopkins Medicine suggests that total hip arthroplasty (THA) patients are more likely to have poorer outcomes if they cannot independently perform daily activities before surgery.
The researchers used the American College of Surgeons National Surgical Quality Improvement Program database to identify 43,179 patients with osteoarthritis who underwent primary THA between 2009 and 2013. Preoperative functional status was used to categorize patients as dependent or independent. Dependent patients were older and had more comorbidities.
The researchers found that dependent patients were 2 to 3 times more likely to experience surgical complications and to spend time in a nursing or rehabilitation facility before going home. They also had a 19% longer length of stay in the hospital.
The findings, published in the journal Orthopedics, led the researchers to conclude that a preoperative assessment of ability to perform daily activities, including taking showers, eating, getting dressed, and going to the bathroom, can be used as a simple tool to help predict postoperative outcomes. This will further help determine if other interventions such as physical therapy are needed beforehand to better prepare the patient for surgery and increase the likelihood of a successful outcome.
“With an aging society, we see an increased number of people who need or are referred for hip replacement surgeries,” says Micheal Raad, MD, first author of the published study and a postdoctoral research fellow in the Department of Orthopaedic Surgery at the Johns Hopkins University School of Medicine.
“However, without a better understanding of factors that influence outcomes after surgery, we may not be making the best treatment plans for our patients, and our study offers a simple tool to help inform treatment decisions.”
The researchers say future studies are needed to explore more precise and standardized ways to measure ADLs.
Raad M, Amin RM, El Abiad JM, Puvanesarajah V, Best MJ, Oni JJ. Preoperative patient functional status is an independent predictor of outcomes after primary total hip arthroplasty. Orthopedics. 2019 Mar 26:1-5. doi: 10.3928/01477447-20190321-01. [Epub ahead of print]