Abstract
To characterize whether medical comorbidity predicts persistent moderate-severe pain after total hip arthroplasty (THA). We analyzed the prospectively collected data from the Mayo Clinic Total Joint Registry for patients who underwent primary or revision THA between 1993 and 2005. Using multivariable-adjusted logistic regression analyses, we examined whether certain medical comorbidities were associated with persistent moderate-severe hip pain 2 or 5 years after primary or revision THA. Odds ratios (ORs), along with 95% confidence intervals (CIs) and P value, are presented. The primary THA cohort consisted of 5,707 THAs and 3,289 THAs at 2 and 5 years, and revision THA, 2,687 and 1,627 THAs, respectively. In multivariable-adjusted logistic regression models, in the primary THA cohort, renal disease was associated with lower odds of moderate-severe hip pain (OR 0.6; 95% CI 0.3, 1.0) at 2 years. None of the comorbidities were significantly associated at 5 years. In the revision THA cohort, heart disease was significantly associated with higher risk (OR 1.7; 95% CI 1.1, 2.6) at 2 years and connective tissue disease with lower risk (OR 0.5; 95% CI 0.3, 0.9) of moderate-severe hip pain at 5-year follow-up. This study identified new correlates of moderate-severe hip pain after primary or revision THA, a much-feared outcome of hip arthroplasty. Patients with these comorbidities should be informed regarding the risk of moderate-severe index hip pain, so that they can have a fully informed consent and realistic expectations.
Highlights
Total Hip Arthroplasty (THA) is a commonly performed joint arthroplasty in the U.S and the annual volume was projected to double by 2030 [1]
The primary THA cohort consisted of 5,707 THAs and 3,289 THAs at 2- and 5-years, and revision THA, 2,687 and 1,627 THAs, respectively
In multivariable-adjusted logistic regression models, in the primary THA cohort, renal disease was associated with lower odds of moderate-severe hip pain (OR, 0.6; 95% confidence intervals (CI), 0.3, 1.0) at 2-years
Summary
Total Hip Arthroplasty (THA) is a commonly performed joint arthroplasty in the U.S and the annual volume was projected to double by 2030 [1]. While evidence exists for association of comorbidities with poorer function after primary THA [11,12,13,14,15], to our knowledge, there are no well-designed studies investigating whether, and which medical comorbidities predict poor pain outcomes after THA. This knowledge would allow more informed patient-surgeon discussion for patients with comorbidities that are risk factors for poor pain outcomes
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