Publication:

Functional outcomes following total hip and knee arthroplasty

Background Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective treatments for advanced osteoarthritis (OA) and other joint disorders. Despite their efficacy, many patients experience residual functional limitations postoperatively. This study evaluates functional outcomes following unilateral THA and TKA, integrating patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs) over 12 weeks.

Methods This prospective observational study, conducted at B. P. Koirala Institute of Health Sciences, Nepal, included adults scheduled for unilateral THA or TKA. Participants completed preoperative questionnaires assessing demographics, health status, joint disabilities, and baseline functional tests, including the 30-second chair stand test (30-s CST) and the HOOS/KOOS. Postoperative follow-ups were conducted at 2, 6, and 12 weeks, assessing functional outcomes, satisfaction, pain, and quality of life (QoL). Paired t-tests and repeated measures ANOVA was used for data analysis in SPSS version 26.0.

Results The study included 38 patients; 24 THA and 14 TKA, with both groups showing significant postoperative improvements in all outcomes (HOOS/KOOS, 30-s CST, pain, and QoL). TKA patients demonstrated better early improvements in pain, symptoms, and physical function at 2 weeks. In contrast, THA patients had greater improvements in sports and recreation scores by 12 weeks. Self-reported QoL showed significant improvements, with no significant differences in age or BMI affecting outcomes. Pain catastrophizing decreased significantly in both groups. Gender differences were found in the THA group, where men improved better in most functional measures.

Conclusions Both THA and TKA result in significant improvements in pain, physical function, and QoL, with PROMs and PBOMs playing complementary roles in tracking recovery highlighting the importance of integrating subjective and objective measures for holistic post-surgical evaluations and personalised rehabilitation strategies.