Early recovery trajectories after total hip replacement: the role of patient characteristics

Abstract

Background: Total hip replacement (THR) is considered to be a successful treatment for end-stage hip osteoarthritis. However, not all patients experience the same amount of improvement after surgery. The aim of the present study is to characterise subgroups of patients based on their recovery experience after THR. Methods: Patients (n = 94) from a single hospital participated in a diary study. For 6 weeks, patients weekly recorded their severity of hip problems (Oxford Hip Score, OHS) after THR. Latent class growth modelling (LCGM) was used to identify patients with the same hip function trajectory and to compare these subgroups on pre- and post-operative patient characteristics. Findings: LCGM revealed a fast (n = 17, 18.1%), average (n = 53, 56.4%) and slow (n = 24, 25.5%) recovery subgroup. Subgroups differed not on baseline OHS, but on the estimated weekly growth rate during the first 2 weeks (fast: 9.52; average: 5.30; slow: 2.68), with less differences between groups in the last 4 weeks (fast: 0.90; average: 2.02; slow: 1.73). Patients in the slow recovery group could be characterised as women of older age (mean age = 69) who rated their health as lower pre-operatively, needed more assistance during recovery, and were less satisfied with the outcomes of the surgery. Discussion: We identified distinct recovery trajectories in the first 6 weeks after THR which were associated with patient characteristics. Our findings suggest that care pathways for THR may need to be tailored to cater to the needs of specific subgroups.