Total hip arthroplasty improves pain and function but not physical activity

Artaban Johnson Jeldi, Angela H. Deakin, David J. Allen, Malcolm H. Granat, Margaret Grant, Ben W. Stansfield

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Background:People with hip osteoarthritis are likely to limit physical activity (PA) engagement due to pain and lack of function. Total hip arthroplasty (THA) reduces pain and improves function, potentially allowing increased PA. PA of THA patients was quantified to 12m post-operation. The hypothesis was that post-operatively levels of PA would increase.Methods:PA of 30 THA patients (67±7 years) was objectively measured pre-operatively and three and 12 months post-operation. Harris Hip Score (HHS), Oxford Hip Score (OHS) and six minute walk test (6MWT) were recorded. Mixed linear modelling was used to examine relationships of outcomes with time, baseline BMI, age, gender and baseline HHS.Results:Time was not a significant factor in predicting volume measures of PA, including sit-to-stand transitions, upright time and steps. Notably baseline BMI was a significant predictor of upright time, steps, largest number of steps in an upright bout, HHS and 6MWT. Baseline HHS helped predict longest upright bout, cadence of walking bouts >60s and OHS. The significant effect of participant as a random intercept in the model for PA outcomes suggested habituation from pre- to post-surgery.Conclusions:Volume measures of PA did not change from pre- to 12m post-surgery despite improvement in HHS, OHS and 6MWT. Baseline BMI was a more important predictor of upright activity and stepping than time. Pre- and post-operative PA promotion could be used to modify apparently habitual low levels of PA to enable full health benefits of THA to be gained.
Original languageEnglish
Pages (from-to)2191-2198
Number of pages8
JournalJournal of Arthroplasty
Issue number7
Early online date10 Feb 2017
Publication statusPublished - Jul 2017


  • total hip arthroplasty
  • physical activity
  • stepping time
  • upright time
  • cadence
  • stepping activity


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