Jiang QL. Influence of frailty on postoperative outcomes following primary and revision total hip arthroplasty. World J Orthop 2025; 16(9): 108400 [DOI: 10.5312/wjo.v16.i9.108400]
Corresponding Author of This Article
Qi-Long Jiang, MD, PhD, Department of Orthopaedic Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, No. 19 Fuhua Road, Chongqing 400043, China. jys19870607@qq.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Sep 18, 2025; 16(9): 108400 Published online Sep 18, 2025. doi: 10.5312/wjo.v16.i9.108400
Influence of frailty on postoperative outcomes following primary and revision total hip arthroplasty
Qi-Long Jiang
Qi-Long Jiang, Department of Orthopaedic Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400043, China
Author contributions: Jiang QL contributed to the manuscript writing and revision.
Supported by the Natural Science Foundation Project of the Science and Technology Bureau of Yuzhong District, Chongqing, No. 20240129.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
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: Qi-Long Jiang, MD, PhD, Department of Orthopaedic Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, No. 19 Fuhua Road, Chongqing 400043, China. jys19870607@qq.com
Received: April 14, 2025 Revised: May 9, 2025 Accepted: July 31, 2025 Published online: September 18, 2025 Processing time: 150 Days and 13.5 Hours
Abstract
Total hip arthroplasty (THA) effectively treats advanced hip disorders, yet outcomes vary among patients. Frailty has become a crucial factor influencing these results. Several studies explored multiple preoperative factors affecting THA outcomes, highlighting the significance of age, Western Ontario and McMaster Universities Osteoarthritis Index, Center for Epidemiologic Studies Depression Scale, and central sensitization index scores in predicting post-operative recovery, emphasizing comprehensive preoperative assessments. Subsequent research has shown that frailty, measured by tools like the hospital frailty risk score and frailty deficit index, is significantly associated with adverse outcomes such as higher 30-day readmission rates, longer hospital stays, increased costs, and elevated mortality and complication risks in both primary and revision THA. Additionally, frailty related to short-term adverse events but stressed the need for standardized frailty measurement. Currently, there is no unified standard for assessing frailty before THA, which hinders cross-study comparison and evidence-based guideline development. Future research should focus on establishing a universal frailty assessment standard considering physical function, comorbidities, cognitive and psychological status. Prospective studies are also needed to clarify the causal relationship between frailty and long-term THA outcomes and identify modifiable factors for preoperative interventions. Overall, understanding the impact of frailty on THA outcomes is essential for improving patient care and resource utilization, especially in an aging population with a rising prevalence of hip disorders.
Core Tip: Total hip arthroplasty (THA) is an effective treatment for advanced hip problems, but patient outcomes vary. Frailty is a key factor influencing these results. Preoperative factors are important for predicting post-operative recovery, underlining the need for comprehensive pre-operative assessments. Tools such as hospital frailty risk score and frailty deficit index show frailty is linked to adverse outcomes in THA, including higher readmission, longer stays, more costs, and greater mortality and complication risks. Understanding frailty’s impact on THA outcomes is crucial for better patient care, especially as hip disorders increase in the aging population.
