Most studies about activity levels after a total hip arthroplasty (THA) or periacetabular osteotomy (PAO) are done on Caucasians. Both of these procedures are commonly performed in patients with acetabular dysplasia. Hara et al, orthopedic surgeons from Japan, performed a study evaluating pre-operative and post-operative activity levels for both procedures in Asian patients.
To begin their research, Hara et al. reviewed data on patients who had either had THA or PAO between January 1998 and December 2011. They had strict inclusion criteria, which were that the patient needed to be alive at the time of their survey, the last surgery must have been performed more than a year earlier, the patient must have been evaluated by a surgeon within the past year, and the patient must not have any physical or mental condition unrelated to the hip joint that may result in bed rest. The control group of the PAO patients had the additional criteria that they must not have had THA for the contralateral hip.
Hara et al. then sent questionnaires to 782 qualifying THA patients (983 hips) and 269 qualifying PAO patients (295 hips). The questionnaires focused on activity levels of patients before and after the procedure, the kinds of sports they participated in, and whether they had undergone treatment for another condition related to their hip disorder. Also included in the questionnaire was the Oxford Hip Score (OHS), an assessment of the pain and the function of the hip in daily activities, and the UCLA activity scale to measure the extent of physical activity.
524 THA patients (626 hips) and 203 PAO patients (232 hips) answered the questionnaire. Then, Hara et al. randomly selected only one hip that had undergone either THA or PAO from each patient, making the patient to hip ratio in the study 1:1. After using univariate and multivariate analyses, the number of patients in the study was further decreased to 295 THA patients and 192 PAO patients. With propensity score matching between these patients, the researchers narrowed to 62 THA patients and 62 PAO patients to directly compare the characteristics between them.
In the end, Hara et al. found that participation in sports and UCLA score significantly increased in Asian patients after THA, and that participation in sports before THA was most highly associated with higher activity levels after the procedure. The researchers hope that their results can be helpful in the difficult decision-making process between THA and PAO for patients with hip disorders.
Hara D, Hamai S, Komiyama K, et al. Sports Participation in Patients After Total Hip Arthroplasty vs Periacetabular Osteotomy: A Propensity Score-Matched Asian Cohort Study. J Arthroplasty 2018;33:423-30.