Limping and patient satisfaction after primary total hip arthroplasty: a registry-based cohort study

Alice Bonnefoy-Mazure; Antoine Poncet; Amanda Gonzalez; Christophe Barea; Didier Hannouche; Anne Lübbeke

doi:10.2340/17453674.2022.3489

Authors

Alice Bonnefoy-Mazure Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals, University of Geneva, Faculty of Medecine, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
Antoine Poncet CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland https://orcid.org/0000-0003-0998-853X
Amanda Gonzalez Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
Christophe Barea Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland https://orcid.org/0000-0003-1781-9453
Didier Hannouche Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
Anne Lübbeke Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

DOI:

https://doi.org/10.2340/17453674.2022.3489

Keywords:

Arthroplasty, Hip, Limping, Satisfaction, Surgical Approach

Abstract

Background and purpose: The influence of postoperative limping on patient satisfaction and amount of limping reduction following THA are not well documented. We (1) assessed if postoperative limping is associated with satisfaction 5 years after THA performed via the lateral or anterior approach; (2) evaluated the influence of surgical approach on amount of limping reduction following THA.
Patients and methods: We conducted a prospective cohort study of primary elective THAs performed in 2002–2013. Limping was assessed before and 5 years after surgery using the Harris Hip limping sub-score. Satisfaction was assessed at 5 years on a 5-point Likert scale. We compared proportions of satisfied patients among groups of limping. Evolution of limping before and after surgery was noted. Analyses were performed overall and stratified by pain and surgical approach. We used univariate and multivariate logbinomial regression models.
Results: 1,257 patients were included (mean age 70 years). 81% had surgery via a lateral and 19% via an anterior approach. Before THA, 60% had moderate to severe limping and all reported pain. After THA, limping and pain improved; 9% of patients were dissatisfied. In multivariate analysis stratified on pain level, limping was associated with higher dissatisfaction. Similar results were obtained after lateral vs. anterior approach.
Interpretation: Postoperative limping impacts patient satisfaction after THA. The association varied by degree of limping and absence or presence of pain. It was independent of surgical approach. 5 years after THA occurrence of limping was largely reduced after both a lateral and an anterior approach, with low evidence of a greater reduction under an anterior approach.