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Return to activity following revision total hip arthroplasty

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Demand for revision total hip arthroplasty (RTHA) continues to grow worldwide and is expected to more than double within the next 1–2 decades. The primary aim of this study was to examine return to function following revision THA in a UK population.

Patients and methods

We assessed 118 patients (132 RTHAs, mean age 65 years SD 13, range 23–88) at a mean follow-up of 7.9 years (SD 4.4) postoperatively. Preoperative age, gender, BMI, social deprivation, operative indication, comorbidities, activity level (UCLA score) and Oxford Hip Scores (OHS) were recorded. Postoperative UCLA score, OHS, EQ-5D, satisfaction levels and performance in activities of daily living (ADLs) were obtained and univariate and multivariate analysis performed.

Results

Mean UCLA activity score improved following RTHA (p < 0.001): UCLA activity score improved in 37% and was unchanged in 50%; 49% of patients engaged in at least moderate level activities (UCLA score ≥ 6). Patient BMI, gender, age and reason for revision did not influence levels of pain, stiffness or activity at follow-up. Preoperative UCLA activity scores (p < 0.001) independently predicted long-term UCLA scores. Independent predictors (p < 0.05) of poor hip-specific function (OHS) following revision included social deprivation, revision for periprosthetic fracture and lower preoperative OHS. Difficulties with ADLs were associated with increasing deprivation, ≥ 3 comorbidities, and revision for periprosthetic fracture or infection (p < 0.05). Overall, 79% of patients remained satisfied or very satisfied following revision THA. Following RTHA, 10% suffered a dislocation and 13% required reoperation for complications.

Conclusion

Revision THA facilitates long-term return to preoperative levels of physical activity in the majority of patients, though activity levels increase in one-third only. Overall over three-quarters are satisfied with their outcome, but revision for periprosthetic fracture or dislocation gives the worse overall outcomes and lower satisfaction levels.

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Authors and Affiliations

  1. Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK

    Gareth S. Turnbull

  2. Department of Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK

    Chloe E. H. Scott, Deborah J. MacDonald & Steffen J. Breusch

Authors
  1. Gareth S. Turnbull
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  2. Chloe E. H. Scott
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  3. Deborah J. MacDonald
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  4. Steffen J. Breusch
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Corresponding author

Correspondence to Gareth S. Turnbull.

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The authors declare that they have no competing interests.

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Turnbull, G.S., Scott, C.E.H., MacDonald, D.J. et al. Return to activity following revision total hip arthroplasty. Arch Orthop Trauma Surg 139, 411–421 (2019). https://doi.org/10.1007/s00402-018-3090-y

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  • DOI: https://doi.org/10.1007/s00402-018-3090-y

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