Hip arthroplasty patient-reported outcome unaffected by back pain in women

Abstract

The effect of pre-operative back pain on outcome following total hip replacement (THR) is ill defined. Patient-reported outcome following THR was assessed using a general health status questionnaire (Short Form 36 Health Evaluation (SF-36)). A regional arthroplasty database was used. Pre-operatively, patients were asked regarding the presence or absence of back pain, and the Harris hip score (HHS) was used to objectively measure hip ‘health’. The SF-36, a general health questionnaire, was assessed pre-operatively and at follow-up intervals to 5 years. Bilateral procedures and patients with a post-operative complication recognised to adversely affect outcome were excluded. After exclusions, data from 860 patients were analysed. Proportionally, more women reported back pain pre-operatively. There was no difference in the pre-operative HHS. The post-operative patient-reported SF-36 scores for men with pre-operative back pain were significantly lower than their peers without back pain. This difference was not seen in women. Women with pre-operative back pain attained post-operative mean values in the SF-36 domains that were similar to their peers with no pre-operative back pain. The presence of pre-operative back pain does not affect patient-reported functional and quality of life outcome in women following THR. Men with pre-operative back pain may not obtain the same degree of improvement in general well-being when compared to their peers without back pain.