Impact of comorbidities on outcome after total hip arthroplasty

Fanny L. Loth, Johannes M. Giesinger, Karlmeinrad Giesinger, Deborah J. MacDonald, A. Hamish R.W. Simpson, Colin R. Howie, David F. Hamilton*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Background: Patient-reported outcome scores gain increasing importance in quantifying clinical success and procedure remuneration. Our aim was to evaluate the impact of comorbidity on joint-specific outcome and general health in patients undergoing elective total hip arthroplasty (THA).

Methods: Longitudinal data on THA procedures were used to evaluate the association between comorbidity and surgical outcome in terms of joint-specific measures and general health (Forgotten Joint Score-12[FJS-12], Oxford Hip Score [OHS], and Short Form-12) at 1-year follow-up. Comorbidities comprised the Charlson comorbidity index (CCI), low back pain(LBP), pain from other joints (POJ), and body mass index.

Results: We analyzed data from 251 THA patients(age: 67.7 ± 11.8 years; 58.2% female). Most common conditions were POJ(75.9%), LBP (55.1%), connective tissue disease (12.1%), and diabetes (5.6%).With regard to postoperative improvement, we did not find statistically significant differences between patients with or without CCI comorbidities(FJS-12, +38.7 vs +43.2, P = .370; OHS, +15.6vs +17.9, P = .100) or POJ (FJS-12, +39.9vs +45.1, P = .325; OHS, +17.3 vs +16.6, P =.645). Patients with LBP showed less improvement on the FJS-12 than those without LBP (+35.6 vs +49.1; P = .002), whereas no difference was found for the OHS (+17.9 vs +16.5; P =.266).

Conclusion: Patients with comorbid conditions report lower preoperative and postoperative outcome scores compared with patients with no such conditions; however, there was no statistically significant association of CCI comorbidities and POJ with postoperative improvement in joint-specific outcomes. LBP was found to have a negative impact on postoperative improvement in terms of joint awareness.

Original languageEnglish
Pages (from-to)2755-2761
Number of pages7
JournalJournal of Arthroplasty
Issue number9
Early online date19 Apr 2017
Publication statusPublished - 1 Sep 2017


  • arthroplasty
  • Oxford hip score
  • Forgotten Joint Score-12
  • comorbidity
  • outcome

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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