Quality of life after total hip arthroplasty according to the indication

Dr Aziza NAIT KHACHATa, Dr Soumia MEFTAHa, Dr Naima EL AMRANIa, Prof Fatima LMIDMANIa, Prof Abdelatif EL FATIMIa

a CHU Ibn Rochd Service de médecine physique

Objective. The aim of this work is to determine the quality of life after rehabilitation for total hip arthroplasty (THA) in our Moroccan context, and according to the indication of THA.

Patients and Methods. This is a prospective study from January 2013 to June 2014 on THA (including 7 bilateral) indicated by severe inflammatory or degenerative hip diseases, and sent to the Physical Medicine and Rehabilitation Ibn Rushd Hospital in Casablanca for functional rehabilitation. The quality of life of our patients was assessed by the Western Ontario and McMaster scale Universities Arthritis Index (WOMAC).

Results. 30 women and 15 men, mean age 47.5 years (20-75 years). 30 THA for severe inflammatory hip disease (including 5 bilateral), 22 PTH (including 2 bilateral) for degenerative hip disease. The mean VAS pain decreased from 60/100 to 12/100. The quality of life of the patients was improved in all cases. We compared the results according to the indication, degenerative hip disease versus inflammatory. The disappearance of pain after joint replacement surgery was similar in both groups. Functional status and quality of life of patients with inflammatory diseases, especially rheumatoid was altered.

Discussion. In our cases, the indications justifying the prosthesis were characterized by the predominance of inflammatory hip disease; this is explained by the systematic recruitment of such patients for postoperative rehabilitation in physical medicine and rehabilitation in this context. Improving the quality of life confirms the good results expected after total hip replacement despite some socio-cultural adaptations needed, especially for religious practice. The difference in quality of life as a function of the indication can be explained by the presence of another particular joint damage in inflammatory diseases.

Keywords : total arthroplasty, hip disease , Quality of life