Influencing factors of hip pain after primary total hip arthroplasty

Abstract

Objective To study the influencing factors of hip pain after primary total hip arthroplasty. Methods Adult patients with complete clinical data who underwent total hip arthroplasty in Sichuan Bazhong Orthopedic Hospital from January 2015 to September 2017 were retrospective analyzed. The cases of evision, long-term chronic pain, malignant tumors, and mental disorders were excluded. Gender, age, body mass index (BMI), complications, replacement types, preoperative assessment, intraoperative index and postoperative complications were recorded. Univariate and multivariate Logistic analyses were used to observe the incidence of postoperative moderate-weight hip pain and the correlation between the above data and the occurrence of severe pain in the hip joint. Results A total of 476 patients (476 hips) were enrolled. The incidence of moderate and severe pain in 476 patients was 9.66%. The single factor analysis showed that replacement site, disease type, hypertension, smoking, and drinking were not the risk factors of moderate and severe pain after primary hip replacement (P>0.05), and the gender χ2=6.145), age(χ2=7.847), BMI(χ2=14.704), hip motion time(χ2=8.043), diabetes(χ2=10.356), American Society of Anesthesiologists classification(χ2=10.654), entry mode(χ2=6.746), type of prosthesis(χ2=5.917), operation time(χ2=5.024), lower extremity deep venous thrombosis (DVT) (χ2=11.145)and postoperative C reactive protein (CRP) (χ2=7.494)were the risk factors for moderate and severe pain after primary hip arthroplasty (P <0.05). The results of multifactor Logistic analysis showed that BMI≥28 kg/m2[OR =3.224, 95%CI (2.059, 8.159)]and lower extremity DVT[OR =6.902, 95%CI (4.574, 13.589)]were the independent risk factors (P <0.05) for severe pain after total hip replacement (P <0.05). Age≥60 years [OR =0.718, 95%CI (0.611, 0.829)] and time for joint motion over two days[OR =0.624, 95%CI (0.417, 0.852)]were the protective factors of moderate and severe pain after total hip replacement (P <0.05). Conclusion The occurrence of moderate and severe hip joint after primary total hip replacement is the result of multiple factors, which should be considered to reduce the incidence of moderate and severe pain following total hip replacement. Key words: Arthroplasty, replacement, hip; Pain; Logistic models