Clinical Rheumatology

, 28:1419

Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty

Original Article

DOI: 10.1007/s10067-009-1267-z

Cite this article as:
Singh, J.A. & Lewallen, D. Clin Rheumatol (2009) 28: 1419. doi:10.1007/s10067-009-1267-z

Abstract

To examine whether patient characteristics predict patient-reported pain and function 2- or 5-years after revision total hip arthroplasty (THA). In a prospective cohort of revision THA patients, we examined whether gender, age, body mass index (BMI), comorbidity (Deyo–Charlson index) and depression predicted moderate–severe hip pain, moderate–severe activity limitation (≥3 activities), dependence on walking aids and use of pain medications, using multivariable regression analysis. Significant predictors of moderate–severe pain at 2- and 5-years were [odds ratio (95% confidence interval)]: female gender, 1.3 (1.0, 1.6) and 1.5 (1.1, 1.9) and age 61–70, 0.7 (0.5, 1.0) and 0.7 (0.5, 1.0; reference (ref), ≤ 60 years). BMI, 30–34.9, 1.4 (1.0, 1.9; ref BMI ≤ 25) and depression, 1.6 (1.0, 2.5) were significantly associated with higher odds of moderate–severe pain at 2 years, but not at 5 years. Significant predictors of nonsteroidal anti-inflammatory drugs (NSAIDs) use 2-years post-revision THA were female gender, 1.4 (1.1, 1 .7), BMI, 30–34.9, 1.4 (1.0, 2.0) and age, 71–80, 0.7 (0.5, 0.9). At 5 years, female gender, 1.6 (1.2, 2.2) was significantly associated with NSAID use. Significant predictors of narcotic use 2-years post-revision THA were older age, 61–70, 0.5 (0.3, 0.7) and 71–80, 0.4 (0.3, 0.7) and depression, 2.4 (1.2, 4.6). At 5 years, women, had significantly higher odds 1.8 (1.1, 2.9) of narcotic use and those in age group 61–70 years, significantly lower odds of narcotic use, 0.4 (0.2, 0.7). Similarly, female gender, older age (>70) and BMI of 30 or higher were each significantly associated with higher odds of moderate–severe activity limitation at both, 2- and 5-years. Depression was associated with higher risk at 2 years, 1.7 (1.1, 2.6) and higher Deyo–Charlson score with a higher risk of moderate–severe activity limitation at 5 years, 1.7 (1.1, 2.7). Obesity and depression, considered modifiable clinical factors, were important independent predictors of pain, functional limitation and use of pain medications, following revision THA.

Keywords

Body mass indexComorbidityDepressionFunctionPainPain medicationsPredictorsTotal hip arthroplasty

Copyright information

© Clinical Rheumatology 2009

Authors and Affiliations

  1. 1.Departments of Health Sciences ResearchMayo Clinic School of MedicineRochesterUSA
  2. 2.Orthopedic SurgeryMayo Clinic School of MedicineRochesterUSA
  3. 3.Rheumatology Section, Medicine ServiceVA Medical CenterMinneapolisUSA
  4. 4.Division of Rheumatology, Department of MedicineUniversity of MinnesotaMinneapolisUSA
  5. 5.Rheumatology (111R)Minneapolis VA Medical CenterMinneapolisUSA