Background/Purpose:  The fastest growing segment of patients who undergo total hip replacement (THR) are younger than <65 years, yet little is known regarding their outcomes as compared to older patients.  We examined, from a national sample of THR patients, differences in clinical outcomes of pain and function following surgery. 

Methods:  Patients undergoing primary THR from 7/1/11 through 12/30/13 for osteoarthritis were identified from a national research consortium which enrolls patients from >130 surgeons across 22 states in the US.  The registry gathers data from patients, surgeons and hospitals on patient demographics, underlying type of arthritis, body mass index, non-arthritis comorbid conditions, arthritis in non-operative hip and knee joints, back pain, global function based on the Short Form 36 Physical Component Score (PCS), and mental health using the SF-36 Mental Component Score (MCS).  We evaluated both change in operative joint pain and function as well as the 6-month post-operative pain and function based on the estimated Western Ontario and McMaster Universities Arthritis Index (WOMAC) using the Hip Disability and Osteoarthritis Outcome Score (HOOS; range 0-100 with higher being better).  Descriptive statistics were performed as well as linear and mixed model multivariable regression models examining differences based on age. 

Results: There were 1030 patients <65 years and 1242 patients ≥ 65 years who underwent primary THR.  Younger patients were more likely to be nonwhite (6.7% vs. 4.1%, p<0.01), heavier (body mass index 29.3 vs. 28.2, p<0.001), with worse emotional health (50.1 vs. 53.1, p<0.001), and fewer comorbid conditions (p <0.001).  At the time of surgery, younger patients had greater pain (47.2 vs. 51.7, p<0.001) and functional impairment (45.2 vs. 47.0, p=0.02).  Overall both younger and older patients had substantial pain relief and functional gain, mean improvement of 40.1 – 43.2 and 39.1 – 42.2 respectively based on the HOOS.  In adjusted analyses, both younger and older patients had similar levels of improvement in pain and function as well as similar mean post-operative 6-month pain (90.4 vs. 91.9, p=0.15) and function scores (86.2 vs. 87.4, p=0.42). 

Conclusion:  Both younger and older THR patients had substantial pain and disability at time of THR, and achieved significant pain relief and functional gain at 6 months following surgery.  In this national sample of THR patients, both younger and older patients had good clinical outcomes following surgery with respect to pain relief and functional gain.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/differences-in-total-hip-replacement-outcomes-based-on-age/