JOA - 2026-05-19 - Journal Article
Functional Outcomes Five to 20 Years After Total Hip Arthroplasty in Patients Under Age 40 Years: A Comparative Study with Asymptomatic Age-Matched Controls.
Bozgeyik-Bagdatli S, Çelebi E, Çağlar Ö
Topics
Key Takeaway
Young THA patients (<40 years) at mean 10-year follow-up demonstrated significantly worse TUG, 5TSTS, HHS, OHS, and SF-12 physical scores compared to asymptomatic age-matched controls (all P<0.001), despite satisfactory pain relief.
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Summary
This study compared functional performance, hip-specific outcomes, and health-related quality of life between 48 patients who underwent THA before age 40 and 48 asymptomatic age-matched controls at 5–20 years postoperatively. THA patients performed significantly worse on TUG and 5TSTS functional tests and scored lower on HHS, OHS, and SF-12 physical component scores (all P<0.001). Mental health scores were equivalent, but fear of prosthesis damage and reoperation was notably elevated in the THA cohort.
Key Limitation
The absence of preoperative functional baseline data prevents determination of whether the observed deficits represent incomplete recovery versus pre-existing functional impairment inherent to the underlying pathology requiring THA at a young age.
Original Abstract
BACKGROUND
Total hip arthroplasty (THA), originally developed for elderly patients who have advanced hip osteoarthritis, is increasingly performed in younger adults. Despite advances in implant technology and surgical technique, functional outcomes five to 20 years after arthroplasty in this population remain limited. This study aimed to compare, at five to 20 years, functional performance, hip-related outcomes, and health-related quality of life between individuals who underwent THA before the age of 40 years and asymptomatic age-matched controls.
METHODS
A prospective cohort study was conducted including 48 patients who had undergone THA (mean postoperative duration: 10 years) and 48 healthy controls. Functional performance was assessed using the timed up and go (TUG) and five times sit-to-stand (5TSTS) tests. Hip-related outcomes (Harris Hip Score (HHS) and Oxford Hip Score (OHS)) and quality of life (Short Form-12 (SF-12)) were evaluated.
RESULTS
Patients in the THA group showed significantly poorer functional performance in both TUG and 5TSTS tests compared with controls (P < 0.001). Hip function scores (HHS, OHS) and SF-12 physical component scores were also lower (P < 0.001), while mental component scores did not differ (P = 0.459). Fear-related perceptions-particularly fear of prosthesis damage and reoperation-were relatively higher among patients in the THA group.
CONCLUSION
Although pain relief and subjective hip function remain satisfactory many years after arthroplasty, younger adults who underwent THA demonstrate persistent deficits in mobility and physical quality of life. Targeted rehabilitation strategies addressing both physical and psychological factors are essential to optimize long-term recovery in young THA patients.