• Liam Z Yapp, Nicholas D Clement, Deborah J Macdonald, Colin R Howie, and Scott Chloe E H CEH http://orcid.org/0000-0002-0012-1596 Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescen.
• Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SY, Scotland, UK. Liam.yapp@nhs.net.
• Arch Orthop Trauma Surg. 2020 Jul 1; 140 (7): 963-971.

BackgroundThe primary aim of this study was to assess how expectation fulfilment changes up to 10 years following total hip arthroplasty (THA).Materials And MethodsThree hundred and forty-six patients completed an expectation questionnaire (encompassing 18 activities), Oxford hip score (OHS) and Short Form (SF)-12 prior to surgery. At 1 year postoperatively, expectation fulfilment was assessed in addition to OHS, SF-12 and patient satisfaction (n = 346). This was repeated in surviving patients with intact THAs at 9.1-9.9 years postoperative (n = 224). Linear regression analysis was used to identify factors independently associated with early (1 year) and late (mean 9.5 years) expectation fulfilment.ResultsPostoperative expectation fulfilment scores declined from 36.5 at 1 year to 33 at late follow-up (95% confidence intervals (CI) 0.0-5.0, p < 0.001). Increased (better) late expectation fulfilment scores were significantly associated with better scores for all PROMs applied at both timepoints. Younger age, greater pre-operative expectation score and greater improvement in OHS (both early and late) were all independent predictors when adjusting for confounding (p < 0.05). At late follow-up 78% (14/18) activities demonstrated high levels of persistent expectation fulfilment. Approximately two out of every five patients who considered themselves unfulfilled at early follow-up went on to experience late fulfilment, but this was dependent upon the specific expectation (mean 40%, range 0-64%).ConclusionsExpectation fulfilment following THA changes with time. The majority of patients report high levels of expectation fulfilment following THA at late follow-up. This information can be used to help manage the longer-term expectations of patients undergoing THA.

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