Pre-op daily life disability may predict poor outcome after hip replacement

A new Johns Hopkins Medicine study looking at medical records of more than 43,000 U.S. adults with hip-joint damaging osteoarthritis suggests that those who cannot perform daily activities independently before total hip replacement surgery are more likely to have poorer outcomes after surgery.

Overall, those less able to care for themselves appeared to be two to three times more likely to have surgical complications and to spend time in a nursing or rehab facility before going home, and to have a 19 percent longer length of hospital stay.

The findings, published in the March 27, 2019, issue of the journal Orthopedics, led the researchers to conclude that a pre-operative assessment of the ability to perform daily activities such as taking showers, eating, getting dressed and going to the bathroom can be used as a simple tool to help predict postoperative outcomes. This will further help determine if other interventions such as physical therapy are needed beforehand to better prepare the patient for surgery and increase the likelihood of a successful result.

"With an aging society, we see an increased number of people who need or are referred for hip replacement surgeries," says Micheal Raad, M.D., first author of the published study and a postdoctoral research fellow in the Department of Orthopaedic Surgery at the Johns Hopkins University School of Medicine. "However, without a better understanding of factors that influence outcomes after surgery, we may not be making the best treatment plans for our patients, and our study offers a simple tool to help inform treatment decisions."

Researchers say future studies are needed to explore more precise and standardized ways to measure daily self-care abilities.