Failure to Meet Expectations of Sport or Recreation Following Total Hip Arthroplasty Is Associated With Younger Age, Higher BMI, and Worse Health

Abstract

OBJECTIVE: To retrospectively identify preoperative factors that may predict failed patient expectations for participation in sports or recreation 12 months following total hip arthroplasty (THA). DESIGN: Observational study. METHODS: Patient-reported outcomes were collected prospectively at 1 hospital in Sydney, Australia, between 2015 and 2018. Age, gender, postcode, and body mass index (BMI) were recorded preoperatively. Included participants underwent primary THA by one of the 3 investigating surgeons. An expectation fulfilment score was used as the primary outcome variable. Preoperative predictor variables included age, gender, BMI, socioeconomic status, Oxford Hip Score, Hip Disability and Osteoarthritis Outcome Score, 5-level EuroQol 5-dimensional questionnaire (EQ-5D-5L), and EuroQol visual analogue scale (EQ VAS). RESULTS: One thousand nineteen participants were included, of which 758 completed full data sets. Thirteen percent did not have expectations met at 12 months. Younger age (odds ratio [OR] = 0.98; 95% confidence interval [CI]: 0.96, 1.00; P = .048), lower preoperative EQ VAS (OR = 0.98; 95% CI: 0.98, 0.99; P = .002), and higher BMI (OR = 1.04; 95% CI: 1.00, 1.09; P = .042) were associated with failed expectations. CONCLUSION: Younger age, higher BMI, and poorer health may predict unmet expectations for sport and recreation after THA. Tailored education in these groups should be considered, and further research should be performed to determine why these groups have increased odds of failed expectations. JOSPT Open 2024;2(3):272-281. Epub 5 April 2024. doi:10.2519/josptopen.2024.0809