A 5-Year Longitudinal Assessment of Quality of Life in Patients Who Have Osteonecrosis of the Femoral Head Undergoing Total Hip Arthroplasty: A Multicenter Study

Background: The effects of surgical treatment on the quality of life (QOL) of patients who have osteonecrosis of the femoral head (ONFH) have been rarely reported. This multicenter study aimed to elucidate the longitudinal QOL in patients who have ONFH undergoing total hip arthroplasty. Methods: Self-assessment QOL questionnaires, including the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), Oxford Hip Score (OHS), and 12-Item Short-Form Health Survey Version 2 (SF-12v2), were administered to 124 patients at 6 months, 1 year, 2 years, and 5 years postoperatively. These scores were compared according to age, sex, and associated factors from preoperative status to 2 years postoperatively (study 1) and from 2 to 5 years postoperatively (study 2). Results: Postoperative JHEQ satisfaction, pain, movement, mental, OHS, and SF-12v2 physical component summary (PCS) scores significantly improved 6 months postoperatively. The satisfaction level and OHS in men and patients aged < 60 years continuously improved significantly until 2 years postoperatively. Postoperative JHEQ movement scores gradually improved in patients aged ≥ 60 years. The SF-12v2 role component summary scores improved significantly 2 years postoperatively. Compared to the scores at postoperative 2 years, JHEQ satisfaction level in the patients aged ≥ 60 years and patients who had corticosteroid-associated ONFH, JHEQ pain and mental scores in women and corticosteroid-associated patients, and JHEQ movement and OHS in women improved significantly at 5 years postoperatively. Women showed better pain visual analog scale for up to 5 years postoperatively. The PCS at postoperative 2 years was significantly better in alcohol-associated patients than in patients who have corticosteroid-associated ONFH; however, there were no significant differences at 5 years postoperatively. The PCS was significantly better in patients aged < 60 years and in women at 5 years postoperatively. Conclusions: Longitudinal change in QOL scores of patients who have ONFH who underwent total hip arthroplasty indicated different improvement patterns according to age, sex, and associated factors.