Predictors of excellent early outcome after total hip arthroplasty

We prospectively collected data on 1318 total hip replacements. Prior to surgery patient characteristics, demographics and co-morbidities were documented. Hip function and general health was assessed using the Harris Hip score (HHS) and the Short-Form 36 respectively. The HHS was repeated at three years. We took a maximal HHS of 100 to represent an excellent outcome (102 patients). Multiple logistic regression analysis was used to identify independent predictors of excellent outcome.The two strongest predictive factors in achieving an excellent result were young age and a high pre-operative HHS (p = 0.001).It was the young and those less disabled from their arthritis that excelled at three years. When making a decision about the timing of hip arthroplasty surgery it is important to take into account the age and pre-operative function of the patient. Whether these patients continue to excel however will be the basis of future research.This study did not receive public or private fundings nor do any authors have a proprietary interest.Total hip arthroplasty (THA) has been shown to provide both significant improvements in the quality of life to patients with hip arthritis [1] but also an excellent cost per Quality-Adjusted Life Year (QALY) gain of half (€6710) that seen in total knee arthroplasty (€13995) [2]. Not all patients however gain the same degree of improvement and the reasons for this are not clear. Many investigators have assessed predictors of outcome after hip surgery [3-7]. This prospective study is unique in its quest for the predictors of the best possible early outcome.Between 1998 and 2004 a dedicated audit nurse collected data prospectively on 1318 consecutive unilateral THA. Ethics committee approval was obtained.Data collected pre-operatively included patient age, sex, body mass index (BMI), smoking status, medical co-morbidities (presence of hypertension, coronary heart disease and diabetes), any use of non-steroidal anti-inflammatory drugs (NSAID