Does Physical Activity Level Influence Total Hip Arthroplasty Expectations, Satisfaction, and Outcomes?

Abstract Background Total hip arthroplasty (THA) patients expect pain relief and functional improvement, including return to physical activity. Our objective was to determine the impact of patients' physical activity level on preoperative expectations and postoperative satisfaction and clinical outcomes in patients undergoing THA. Methods Using an institutional registry of patients undergoing THA between 2007 and 2012, we retrospectively identified patients who underwent unilateral primary THA for osteoarthritis and completed a preoperative Lower Extremity Activity Scale (LEAS), Hospital for Special Surgery Hip Replacement Expectations Survey (HSS-HRES), and Hip disability and Osteoarthritis Outcome Score (HOOS) in addition to two-year HOOS and satisfaction evaluations. Active patients (n=1053) were matched to inactive patients (n=1053) by age, sex, body mass index, and comorbidities. The cohorts were compared with regard to the association of expectations with HOOS and satisfaction, the change in LEAS level from baseline to 2 years, complications, and revision surgical procedures. Results Significantly more active patients (74%) expected to be "back to normal" regarding ability to exercise and participate in sports compared with inactive patients (64%, p Conclusions At 2 years following THA, active and inactive patients were similarly satisfied and achieved comparable outcomes. Inactive patients showed a greater improvement in physical activity level from preoperative baseline than active patients. Complications and revision rates were similar. Level of Evidence III