Differences in one year outcome after primary total hip and knee arthroplasty in elderly patients with osteoarthritis: a cohort study

H. Zhai 1, H. Geng 1, B. Bai 2, Y. Wang 1

1 Rehabilitation Medicine, Shenzhen Second People’s Hospital, Shenzhen, China; 2 Orthopedics, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

Background. Patients submitted to primary total hip (THA) and knee (TKA) arthroplasty show better clinical outcomes, improved quality of life and increased participation in leisure activities. However, the discrepancy between primary THA and TKA in elderly patients are unknown. 

Aim. To compare the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) scores and WOMAC change scores, the Medical Outcomes Study 12-item short-form version 2 (SF-12) mental and physical health scales, satisfaction, and frequency of participation in leisure activities in elderly osteoarthritis patients (≥ 65 years) who underwent primary THA and TKA, respectively.

Methods. Data from 170 THA and 169 TKA patients were collected one week preoperatively through self-reporting of WOMAC scores, and SF-12. One year postoperatively, the latter parameters and satisfaction frequency for participation in leisure activities were collected by self-reporting questionnaires. 

Results. THA group patients showed better WOMAC scores (p < 0.05), WOMAC change scores (p < 0.05), physical component summary (PCS) of SF-12 (p < 0.01), and PCS change scores (p < 0.01) compared with the TKA group. In addition, THA patients showed higher overall satisfaction (91.90 vs 83.60%), pain relief satisfaction (87.20 vs 77.40%), and functional improvement satisfaction (90.10 vs 83.08%) in comparison with TKA patients. Furthermore, higher frequency of participation in leisure activity was obtained in THA patients, except the intellectual leisure activity.

Conclusions. Our findings suggest that primary THA offers superior clinical outcomes, quality of life, satisfaction, and participation in leisure activity compared with primary TKA in elderly patients. 

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