Expectations and depression in patients who have undergone total hip arthroplasty in Japan: A prospective cohort study

Background: Patients with hip osteoarthritis may be severely depressed preoperatively due to pain and limited daily-living activities. Hence, evaluating their expectations preoperatively might underestimate their true hopes regarding the upcoming total hip arthroplasty (THA). Aim: We aimed to assess changes in patients’ level of depression, understand their expectations and fulfillment, and identify factors affecting fulfillment. Method: We performed a longitudinal study of 366 Japanese patients who had undergone THA during 2005–2006. Those with THA of the contralateral hip were excluded. Patients’ expectations, fulfillment, depression, and physical function were assessed perperative and at 6 weeks and one year postoperatively using our own questionnaire, the Arthritis Impact Measurement Scale 2, and by the Oxford Hip Score . Logistic regression analysis was applied to identify independent predictors of expectation fulfillment. Results: At 6 weeks, 78.1% expressed expectation fulfillment and drastic alleviation of depression. Preoperative depression and fulfillment of patient expectations at 6 weeks were significant predictors of expectation fulfillment at 1 year (95% confidence intervals: 1.01–2.48 and 2.30–9.92, respectively. Conclusions: It is worthwhile for health providers to investigate patients’ expectations early in the postoperative period by considering their preoperative depression to confirm fulfillment of expectations.