Evaluation of general health status in total hip arthroplasty patients, 30- year cohort study

Background : Total hip arthroplasty (THA) is the primary treatment for severe joint damage and represents a significant surgical advancement of the century. This study aims to evaluate the long-term health-related quality of life (HRQoL) of THA patients, based on a remarkable follow-up period of 30 years after surgery. Methods: This is a retrospective comparative cohort study in Latin American population. The cohort includes all THA performed between January 1, 1990, and December 31, 2020. A total of 458 patients from this database were evaluated, with a follow-up period of 30 years. Our population showed a high frequency of patients with rheumatoid pathologies (RP); therefore, we performed a simple random sampling to balance the number of cases for comparison between the two study groups: the osteoarthritis (OA) group and the RP group. For functional assessment, the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used. At the same time, pain was assessed using a Numeric Rating Scale (NRS). THA survival was evaluated using the Kaplan-Meier method and to assess HRQoL with the Short Form 36 Health Survey (SF-36). A p-value of less than 0.05 was considered statistically significant. Results : THA positively affects pain relief, physical function, mental health, and social participation. To achieve an excellent postoperative outcome, it is essential to optimize both the physical and emotional aspects before and after surgery. The ultimate goal is to enhance patients' quality of life. Conclusions : THA should be complemented by physical and psychosocial optimization strategies both before and after surgery, incorporating a multidimensional assessment and extended follow-up. Trial registration: Not applicable, this study is an observational retrospective cohort; no prospective registration was required.