Radiographic stage of osteoarthritis or sex of the patient does not predict one year outcome after total hip arthroplasty

Objective-To investigate whether patients with severe radiographic osteoart hritis (OA) have a different outcome at one year after total hip replacemen t than patients with moderate radiographic OA. To investigate sex related d ifferences in preoperative radiographic and self reported status and in pos toperative outcome. Methods-184 patients (96 women) with a mean age at surgery of 71.4 years (5 0-92), with primary OA of the hip were investigated preoperatively and six and 12 months postoperatively with two self administered questionnaires, SF -36 and WOMAC. The radiographs were evaluated by two independent radiologis ts using an atlas. Minimal joint space narrowing, osteophytes, cysts, scler osis, and deformity were assessed. A summary grade 0-3 was made, based on j oint space, where 3 is severe OA. The reference population for SF-36 consis ted of 2901 subjects matched for age and sex from the general Swedish popul ation. Results-162 patients fulfilled the study criteria. 113 had grade 3, 47 grad e 2, and two grade 1 radiographic OA. There was no difference in preoperati ve or postoperative pain and physical impairment between patients with mode rate and severe radiographic OA. There were no sex related differences in p reoperative radiographic status, or in postoperative outcome. Neither were any differences in preoperative radiographic status of OA found in patients with previous total hip replacement of the contralateral hip, compared wit h those who had not been operated on before. All patients, regardless of pr eoperative radiographic OA stage, showed significant postoperative improvem ent and at one year achieved a health related quality of life similar to th at of the reference group. Conclusion-The severity of radiographic changes indicating OA often weighs heavily in the surgeon's decision to perform a total hip replacement. Yet, the findings of this study emphasise that the preoperative radiographic sta ge of OA has no correlation with the postoperative outcome after one year. Furthermore, this study failed to detect any sex related differences in pre operative radiographic and self reported status or in postoperative outcome of hip replacement.