Outcomes and health-related quality of life in total hip replacement patients: Evidence from orthopedists of three medical centers

Objectives: The major purpose of the study was to examine the outcomes and health-related quality of life for Total Hip Replacement (THR) patients following the operation. Furthermore, to explore the difference in the degree of patients improvement among the three medical centers in southern Taiwan. Methods: A prospective study was designed. The study sample was derived from one orthopedic surgeon from each medical center. In total, 200 THR patients (hips) had the preoperative and postoperative assessments. The Chinese version of the Harris Scale and the Chinese-version of the Short-form 36-item Health Survey (SF-36) were used as measures. The assessments were conducted before and six months after the operation by orthopedists and trained interviewers. Results: In terms of the Harris Hip Score and the SF-36 scores, the THR patients in the three hospitals showed improvements before and after the operation (p<.001). In each domain of the Harris Hip Scale, the improved score for pain relief was the highest. This was followed by gait function and activity function. In the SF-36, the most significant improvement was found in the domain of role limitations due to emotional problems (RE), and followed by role limitation due to physical problems (RP). Among the three study hospitals, significant differences were found in the total Harris Hip Score and scores on three domains of the SF-36 (physical functioning, role limitation due to emotional problems, and social functions) (p<.05). Conclusions: The present study confirms that THR did enhance patients' physical functioning and health-related quality of life. The degree of improvement in several dimensions of outcome measurement varied significantly by hospital. It is suggested that using generic measures should be considered as a supplemental measurement for the outcome study.