Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty

Clin Rheumatol. 2009 Dec;28(12):1419-30. doi: 10.1007/s10067-009-1267-z. Epub 2009 Aug 31.

Abstract

To examine whether patient characteristics predict patient-reported pain and function 2- or 5-years after revision total hip arthroplasty (THA). In a prospective cohort of revision THA patients, we examined whether gender, age, body mass index (BMI), comorbidity (Deyo-Charlson index) and depression predicted moderate-severe hip pain, moderate-severe activity limitation (> or = 3 activities), dependence on walking aids and use of pain medications, using multivariable regression analysis. Significant predictors of moderate-severe pain at 2- and 5-years were [odds ratio (95% confidence interval)]: female gender, 1.3 (1.0, 1.6) and 1.5 (1.1, 1.9) and age 61-70, 0.7 (0.5, 1.0) and 0.7 (0.5, 1.0; reference (ref), < or = 60 years). BMI, 30-34.9, 1.4 (1.0, 1.9; ref BMI < or = 25) and depression, 1.6 (1.0, 2.5) were significantly associated with higher odds of moderate-severe pain at 2 years, but not at 5 years. Significant predictors of nonsteroidal anti-inflammatory drugs (NSAIDs) use 2-years post-revision THA were female gender, 1.4 (1.1, 1 .7), BMI, 30-34.9, 1.4 (1.0, 2.0) and age, 71-80, 0.7 (0.5, 0.9). At 5 years, female gender, 1.6 (1.2, 2.2) was significantly associated with NSAID use. Significant predictors of narcotic use 2-years post-revision THA were older age, 61-70, 0.5 (0.3, 0.7) and 71-80, 0.4 (0.3, 0.7) and depression, 2.4 (1.2, 4.6). At 5 years, women, had significantly higher odds 1.8 (1.1, 2.9) of narcotic use and those in age group 61-70 years, significantly lower odds of narcotic use, 0.4 (0.2, 0.7). Similarly, female gender, older age (>70) and BMI of 30 or higher were each significantly associated with higher odds of moderate-severe activity limitation at both, 2- and 5-years. Depression was associated with higher risk at 2 years, 1.7 (1.1, 2.6) and higher Deyo-Charlson score with a higher risk of moderate-severe activity limitation at 5 years, 1.7 (1.1, 2.7). Obesity and depression, considered modifiable clinical factors, were important independent predictors of pain, functional limitation and use of pain medications, following revision THA.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / rehabilitation
  • Body Mass Index
  • Cohort Studies
  • Comorbidity
  • Depression / epidemiology*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Minnesota / epidemiology
  • Obesity / epidemiology*
  • Osteoarthritis, Hip* / complications
  • Osteoarthritis, Hip* / epidemiology
  • Osteoarthritis, Hip* / physiopathology
  • Pain, Postoperative* / epidemiology
  • Pain, Postoperative* / etiology
  • Pain, Postoperative* / physiopathology
  • Postoperative Complications
  • Prospective Studies
  • Recovery of Function
  • Reoperation
  • Sex Factors
  • Treatment Outcome