Quality of life before and after total hip arthroplasty

Purpose of the study: Quality of Life of patients with Total Hip Arthroplasty is analysed before and one year after surgery. The evaluation included the functional capacity of our patients in every day life comparing the preoperative situation with the result one year after surgery. Age and duration of symptoms were analysed with respect to their influence on the success of the procedure. Finally the question should be answered, if clinical examinations and questionnaires concerning Quality of Life result in comparable data. Method: 101 patients with an average age of 64.2 years were included into this study. All patients were evaluated preoperatively and one year after surgery using the Harris Hip Score, questionnaires for Qualitiy of Life of the patients included the Nottingham Health Profile and the Functional Questionnaire Hannover. Results: The pre- and postoperative means of the Nottingham Health Profile showed in five of the six dimensions a significant improvement of Quality of Life (pain, mobility, energy, emotional reaction, sleep). Only the scale "social isolation" remained unchanged between the pre- and postoperative situation. The means of the functional capacity according to the Hannover questionnaire improved from 57.92 to 39.79, a highly significant result. The Harris Hip Score was poor in 97% of the preoperative evaluations. This score improved to 80.2% excellent or good, 7.9% fair and 11.9% poor at one year after surgery. Age and duration of symptoms had no influence in any parameter of Quality of Life. A classification of parameters on Quality of Life according to the Harris-Hip-Score at the 1-year results demonstrates a clear grading concerning the excellent and poor results. Based on the patients evaluations a differentiation between good and poor results is not recorded. Conclusions: The objective evaluation of results after implantation of a total hip joint-endoprosthesis should not be based only on clinical scores (f.e. Harris-Hip-Score). Subjective informations by the patients using questionnaires on Quality of Life (f.e. NHP, FFbH-R) have to be included into these evaluations. The different judgements of the outcome of surgery underline the necessity, not only to use clinical scores but also to include the patients' feeling into the interpretation of the clinical result.