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Mental Health as a Predictor for Patient Reported Outcome after a Total Hiparthroplasty - A Prospective Cohort Study

Randi Bilberg, Birgitte Nørgaard, Kirsten Kaya Roessler and Søren Overgaard

Background: Total hip arthroplasty (THA) is often very successful in patients with severe hip pain and endstage-
osteoarthritis; however a minority of patients has less favorable outcomes.
Aim: To investigate whether patients’ preoperative mental health is a predictor for patient-reported outcome
(PRO) after THA.
Method: The prospective cohort study included 207 patients over a 14-month period, with two follow-ups.
Patients completed the Common Mental Disorders – Screening Questionnaire, Oxford Hip Score, and Euro Qol 5
Dimension questionnaire before surgery and at twelve and 52 weeks after surgery. Data were analysed by multiple
linear regression and t-tests.
Results: Significantly improvement outcomes between baseline and postoperative follow-ups were reported.
Age, gender and BMI together with EQ-5Dindex showed significant regression coefficients. Older, higher BMI and to
by a women were predictor for the worse patient reported outcome (OHS) after twelve weeks. An inferior score on
quality of life (EQ-5Dindex) at baseline predict a minor PRO after twelve weeks. After 52 weeks, concern and
EQ-5Dvas showed significant regression coefficients of PRO as patient with a high score of concern; scores higher
on PRO (OHS) after 52 weeks. Patients with a poorer quality of life measured by EQ-5Dvas were having a higher
score at OHS as a worse outcome of surgery.
Conclusion: Concern measured at baseline can predict PRO after 52 weeks while age, gender and BMI are the
prime predicts after twelve weeks. The development of patients’ mental health, as they undergo a THA from
baseline to 52 weeks postoperative, needs further investigating.