QUALITY-OF-LIFE OUTCOMES FOLLOWING TOTAL HIP ARTHROPLASTY USING SHORT FORM 36 HEALTH SURVEY: A 5-YEAR FOLLOW-UP.

Abstract

Introduction: SF-36 is a validated 36-item questionnaire that measures eight dimensions of quality of life(QoL): physical functioning(PF), role physical(RP), role emotional(RE), social functioning(SF), mental health(MH), energy/vitality(EV), bodily pain(Pain) and general health perception(GHP). The primary aim of the study was to evaluate QoL outcomes after total hip replacement(THR) using SF-36.

Methods: From 5/1/1998 until 16/8/2005, we prospectively collected data on 569 patients who had THR in Fife. 30 of them had bilateral THR. Each patient was assessed pre-operatively and was reviewed at 6 months, 18 months, 3 years and 5 years post-operatively. A SF-36 was filled in at each appointment.

Results: During the period, 6 patients died, 4 had revision, 19 were lost to follow-up and 46 did not attend their 5-year review. Subsequently, 494 patients had a 5-year review but 46 of them did not fill in the questionnaire. Analysis was performed on the remaining 448 patients (male=179, female=269).

Mean scores of PF, RP, RE, SF, EV and Pain improved significantly following THR. The improvement remained significant throughout the follow-up (p< 0.0005). MH was the only dimension which did not change significantly after THR. There was a significant decline in GHP (p< 0.0005).

Females reported lower scores in all dimensions apart from GHP. They were also significantly older than the males (66.66±9.41 vs. 64.69±10.27 years; p< 0.037).

Patients who had unilateral or bilateral THR reported similar scores preoperatively and in the initial follow-up. Significant differences were only noted at 3 and 5 years with the bilateral group reported a higher score.

Discussion: THR improved QoL and the benefit was still evident at 5 years post-operatively. However the perception of general health continued to deteriorate, probably due to the effects of aging. More advanced age of females might partly contribute to their lower scores.