Predicting Outstanding Results Following Primary Total Hip Arthroplasty Using the Maximal Outcome Improvement Threshold
Authors: Maldonado DR, Padmanabhan S, Nerys-Figueroa J, Gattu N, Schinsky MF, Domb BG
DOI: 10.1016/j.arth.2024.10.119
Journal: Journal of Arthroplasty, 2025
Objective
To define outcome thresholds that represent “outstanding” results following primary total hip arthroplasty (THA) using improvement in patient-reported scores.
Methodology
A prospective study of 584 THA patients, followed for a minimum of 2 years, using improvement thresholds in the Forgotten Joint Score (FJS), Harris Hip Score (HHS), and Visual Analog Scale (VAS) for pain to define optimal recovery.
Key Findings
- "Outstanding" outcomes were defined by:
• FJS improvement ≥ 54.2%
• HHS improvement ≥ 65%
• VAS pain improvement ≥ 67.1% - Significant average improvements were achieved across all metrics.
- No single set of preoperative characteristics reliably predicted which patients would reach these thresholds.
Conclusion
These thresholds provide a data-driven framework for evaluating success after THA, improving both patient counseling and outcome benchmarking.
What Does This Mean for Providers?
These improvement thresholds serve as valuable tools for assessing postoperative outcomes and surgical quality. While they may not predict who will succeed preoperatively, they can help providers retrospectively evaluate outcomes and refine patient expectations. Surgeons should incorporate these metrics into follow-up protocols and use them to guide conversations around recovery goals, satisfaction, and potential need for further interventions.