Hip Replacement Surgery Improves Patients’ Quality of Life

    Patients undergoing total hip arthroplasty (THA) experience meaningful and lasting improvements in quality of life (QOL) for at least 5 years after the procedure, according to a study published in The Journal of Bone & Joint Surgery.

    As pain and functioning improve after THA, so do scores on the Short Form-6D (SF-6D), a widely used measure of patient-perceived QOL, according to new research from Michael A. Mont, MD, and colleagues. “The SF-6D is one of the few straightforward, easily obtainable methods that provide clinicians quantifiable insight into a patient’s quality of life,” they write in the article.

    Evaluating 6 QOL Domains

    The researchers analyzed data on 188 patients with an average age of 69 who underwent THA at 7 hospitals. Patients were evaluated with a standard QOL assessment, called the Short Form 36 (SF-36), from which the SF-6D scores were calculated.

    The SF-6D provides scores for 6 QOL domains:

    • Vitality
    • Pain
    • Mental health
    • Social and physical functioning
    • Role limitations

    The SF-6D has been used to assess the health benefits and economic value of many different treatments.

    The results showed significant increases in the SF-6D score from pre-THA to post-THA. Although scores peaked at 1 year, the improvement remained significant through 5 years of follow-up.

    Furthermore, the gains in SF-6D score remained well above the cutoff point for a large effect size, indicating clinically relevant improvement in QOL. The SF-6D scores corresponded to lasting improvements on standard assessments of hip pain and motion, as well as the ability to perform activities of daily living.

    Demonstrating Value of THA

    At a time of increased focus on the economic sustainability of the healthcare system, it is important to document the value of healthcare interventions. Total hip arthroplasty is an effective procedure for which demand is expected to increase in the future. The new study appears to be the first to show that the SF-6D – an easy-to-use QOL measure – confirms the positive patient-perceived impact of THA.

    Like other QOL assessments, the SF-6D has some disadvantages. However, Dr. Mont and his co-authors note, “The SF-6D provides clinicians with a method of quantifying patient satisfaction and perception of their own health.” This is an important concept in assessing the value, or utility, of the procedure.

    Another key advantage is the ability to calculate the SF-6D score from the SF-36 assessment. Dr. Mont and colleagues conclude: “Therefore, widely incorporating the SF-6D into future postoperative assessments is straightforward, and having these values readily available may make prospective cost-effectiveness analyses considerably easier.”


    Elmallah RK, Chughtai M, Adib F, Bozic KJ, Kurtz SM, Mont MA. Determining health-related quality-of-life outcomes using the SD-6D following total hip arthroplasty. Journal of Bone & Joint Surgery. 2017 March 15;99(6):494-8