Patient reported outcomes during the first month following anterior and posterior total hip arthroplasty and hip resurfacing.

Overview

abstract

BACKGROUND: Surgical treatment for osteoarthritis of the hip includes hip resurfacing (HR) and total hip arthroplasty (THA) via various surgical approaches. The discussion about the benefits and preferability of each procedure is highly controversial. We aimed to quantify the patients' utilization of opioids within the first 30 days following surgery and hypothesized that there are no differences in pain, medication, ability to walk, and function between direct anterior approach THA (DAA-THA), posterior approach THA (PA-THA), and HR. METHODS: This retrospective study evaluated 207 hips in 199 patients (DAA: 126 hips, PA: 59, HR: 21), who underwent surgery for primary osteoarthritis between 2020 and 2022. Patients used an app (SeamlessMD, Toronto, Canada) to report pain, utilization of opioids, additional pain medication, walking distance, swelling, and wound drainage for 30 days and HOOS-JR and satisfaction at one month after surgery. Results were compared between the groups after adjusting for age and BMI and patient satisfaction was correlated with pain and function. RESULTS: Opioid cessation was 99% 20 days after surgery. HOOS-JR improvement from pre- to postoperative was 23 points on average (-29-82, SD 15) and was significant in all groups (p < 0.001). No differences in pain, the dosage of opioids and complications were found between DAA-THA, PA-THA and HR. CONCLUSION: The current data showed a high rate of opioid cessation (99%) within 3 weeks following hip reconstructive surgery. DAA-THA, PA-THA, and HR provided comparable opioid usage, function, and a low early complication rate within the first month after surgery.