Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2025; 16(4): 105273
Published online Apr 18, 2025. doi: 10.5312/wjo.v16.i4.105273
Impact of preoperative factors on clinical outcomes after total hip arthroplasty
Toru Nishiwaki, Hisatoshi Ishikura, Yuji Masuyama, Sho Fujita, Rei Hirose
Toru Nishiwaki, Hisatoshi Ishikura, Yuji Masuyama, Sho Fujita, Department of Orthopaedic Surgery, Shizuoka Red Cross Hospital, Shizuoka 420-0853, Japan
Rei Hirose, Department of Orthopaedic, Shizuoka Red Cross Hospital, Shizuoka 420-0853, Japan
Author contributions: Nishiwaki T organized the study and wrote the manuscript; Ishikura H, Masuyama Y, Fujita S, and Hirose R conceived the study and conducted data curation; and all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Shizuoka Red Cross Hospital, approval No. 2023-36.
Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data is available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toru Nishiwaki, Department of Orthopaedic Surgery, Shizuoka Red Cross Hospital, 8-2 Oitecho, Aoi-ku, Shizuoka 420-0853, Japan. tornish@gmail.com
Received: January 18, 2025
Revised: March 5, 2025
Accepted: March 31, 2025
Published online: April 18, 2025
Processing time: 90 Days and 22.9 Hours
Abstract
BACKGROUND

Although total hip arthroplasty (THA) is an established intervention for advanced hip disorders, not all patients achieve the anticipated functional improvements.

AIM

To investigate the impact of various preoperative factors on clinical outcomes after THA.

METHODS

Data of 411 patients who underwent unilateral THA were retrospectively analyzed. The associations between preoperative factors, such as age, body mass index, pain severity, functional impairment, psychological status, neuropathic pain, and central sensitization, and clinical outcomes assessed six months postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and modified Harris Hip Score were evaluated.

RESULTS

Our results indicated that age and the WOMAC, Center for Epidemiologic Studies Depression Scale, and Central Sensitization Index (CSI) scores significantly predicted the modified Harris Hip Score outcomes, whereas age and preoperative WOMAC, EuroQol 5 dimensions, Center for Epidemiologic Studies Depression Scale, CSI, and Pain Detect Questionnaire scores were significant predictors of WOMAC outcomes. Age, WOMAC, and CSI were consistently significant factors. There were no significant differences in the operative time or blood loss across the outcome categories.

CONCLUSION

Our findings highlight the importance of preoperative assessment of central sensitization and psychological parameters. Patient-specific preoperative characteristics may play a greater role than intraoperative factors in determining recovery outcomes after THA.

Keywords: Modified Harris Hip Score; Western Ontario and McMaster Universities Osteoarthritis Index; Central sensitization; Neuropathic pain; Total hip arthroplasty

Core Tip: This study reveals that preoperative factors, particularly central sensitization (Central Sensitization Index), psychological status (Center for Epidemiologic Studies Depression Scale), and functional impairment (Western Ontario and McMaster Universities Osteoarthritis Index), significantly influence recovery outcomes after total hip arthroplasty. Unlike intraoperative factors, these patient-specific characteristics strongly predicted clinical scores at six months postoperatively. Notably, age, Western Ontario and McMaster Universities Osteoarthritis Index, and Central Sensitization Index were consistent predictors across outcomes, emphasizing the importance of comprehensive preoperative evaluations. These findings underscore the critical role of addressing central sensitization and psychological health in optimizing recovery after total hip arthroplasty, offering valuable insights for personalized patient management and improved functional outcomes in advanced hip disorder interventions.