Quality of Live of Patients in the Evaluation of Outcomes of Short Stem Hip Arthroplasty for Hip Osteoarthritis

Abstract

BACKGROUND. The aim of the study was to evaluate clinical outcomes and broadly defined quality of life in patients with hip osteoarthritis after short stem hip arthroplasty. MATERIAL AND METHODS. The study enrolled patients operated on at the Trauma and Orthopedics Department of St. Luke's Regional Hospital in Tarnów in the years 2008-2010. The experimental group consisted of 67 patients aged 22 to 77 years (average age 54.0 years) who received Proxima short stem implants (DePuy, J&J, USA). The control group consisted of 68 patients, operated on at the same department and in the same period, who were implanted with the ABG II prosthesis with a classic anatomical stem (average age 62.2 years). The average duration of hospital stay was 8 days. Follow-up examinations were scheduled at 6 weeks, 3 months and subsequently once a year. Post-operative outcomes were evaluated with the Harris Hip Score (HHS), WOMAC index and NRS. RESULTS. Analysis of HHS scores in the experimental group showed that 89.6% of the patients demonstrated excellent and good outcomes. The hip range of motion improved significantly after arthroplasty compared to preoperative values. The mean standardized extended WOMAC score was 85.5. Pain intensity in the experimental group decreased significantly after surgery. The mean preoperative NRS score was 6.6 vs. 1.0 after surgery. The outcomes in the control group were also excellent and good, but far worse than those in the experimental group as regards both clinical status and quality of life. A comparison of HHS scores showed statistically significant differences between the groups (p=0.018). The mean WOMAC score in the control group was 77.0, which is a statistically significant difference compared to the figure in the experimental group (p=0.001). Both groups had lower NRS scores after surgery, but the values were significantly worse in the control group (p=0.001). CONCLUSIONS. The outcomes of Proxima short stem arthroplasty in patients with hip osteoarthritis were better than the outcomes of patients who were implanted with the classic anatomical ABG stem. Pain reduction and an increased hip range of motion had the strongest impact on improving patients' quality of life after short stem prosthesis hip arthroplasty.