title: Predictors of activity limitation and dependence on walking aids after primary total hip arthroplasty.
abstract: OBJECTIVE
  To study function outcomes and their predictors after primary total hip arthroplasty (THA).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Mayo Clinic.
  
  
  METHODS
  All patients who underwent primary THA at the Mayo Clinic between 1993 and 2005 and were alive at the time of follow-up.
  
  
  METHODS
  Whether sex, age, body mass index (BMI), comorbidity, anxiety, and depression predict moderate to severe activity limitation (limitation in ≥3 activities) and complete dependence on waling aids 2 and 5 years after primary THA was examined. Multivariable logistic regression adjusted for operative diagnosis, American Society of Anesthesiologists score, implant type, and distance from medical center.
  
  
  RESULTS
  At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation. Significant predictors of moderate to severe activity limitations at 2-year follow-up were female sex (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.1-1.4), aged 71 to 80 (OR=2.0, 95% CI=1.6-2.5), aged 80 and older (OR=4.5, 95% CI=3.4-6.0), depression (OR=2.1, 95% CI=1.6-2.7), and BMI greater than 30.0. At 5-year follow-up, significant predictors were aged 71 to 80 (OR=1.7, 95% CI=1.3-2.2), older than 80 (OR=4.3, 95% CI=2.8-6.6), depression (OR=2.3, 95% CI=1.6-3.4), and BMI greater than 30.0.Significant predictors of complete dependence on walking aids at 2 years were female sex (OR=2.0, 95% CI=1.4-2.7), aged 71 to 80 (OR=2.4, 95% CI=1.4-4.2), older than 80 (OR=11.4, 95% CI=6.0-21.9), higher Deyo-Charlson score (OR=1.5, 95% CI=(1.1-1.2) for 5-point increase, depression (OR=2.0, 95% CI=1.2-3.4), and BMI greater than 35.0. Each of these factors also significantly predicted complete dependence on walking at 5-year follow-up, with similar odds ratios, except that BMI of 30.0 to 34.9 was not significantly associated.
  
  
  CONCLUSIONS
  Higher BMI, depression, older age, and female sex predict activity limitation and complete dependence on walking aids 2 and 5 years after primary THA.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic School of Medicine, Rochester, Minnesota, USA. jasvinder.md@gmail.com
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation*; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D012656:Self-Help Devices; D017678:Sex Distribution; D016896:Treatment Outcome; D014853:Walkers; D016138:Walking