# Prognostic value of early proms for one-year recovery trajectories after total hip arthroplasty

## TL;DR

Early recovery after hip replacement surgery predicts long-term outcomes, suggesting the need for early targeted interventions to improve results.

## Contribution

This study shows that early recovery trajectories after THA predict one-year outcomes, emphasizing the importance of early intervention.

## Key findings

- Early postoperative recovery trajectories are predictive of long-term outcomes after THA.
- Patients with unsatisfactory early recovery do not reach comparable outcome levels at twelve months.
- Additional interventions at follow-up visits did not improve outcomes for patients with early unsatisfactory results.

## Abstract

The improvement of outcome quality and patient satisfaction in total hip arthroplasty (THA) requires a holistic approach. The purpose of this prospective study was to determine whether early postoperative interventions are associated with outcomes one year after THA. A total of 770 patients were assessed for satisfaction and quality of care. Patients were divided into those with and without a physical follow-up examination at the clinic three months postoperatively. Examined patients were subdivided into those with satisfactory or unsatisfactory outcomes. Those with an unsatisfactory 3-month result received targeted therapeutic or diagnostic interventions. Patients with an unsatisfactory clinical examination at three months served as the anchor group to derive a postoperative Oxford Hip Score (OHS) threshold. This threshold was subsequently applied to patients without a physical follow-up examination to identify those at higher risk versus those who had likely achieved a satisfactory outcome. Apart from the OHS, the European Quality of Life 5 Dimensions (EQ-5D) and the EndoCert Risk Score (ERS) were used to determine recovery. Although patients showed progress in rehabilitation and pain reduction, these improvements could not be attributed to the additional measures initiated at the follow-up visit. Intervention measures did not enable patients with unsatisfactory three-month results to reach the outcome levels of those who achieved satisfactory early recovery. Patients with poorer outcomes three months after surgery did not reach comparable PROM levels at twelve months. This finding suggests that early postoperative recovery trajectories are predictive of long-term outcomes. Identifying these patients early and offering targeted multidisciplinary treatment concepts may help improve outcome quality and cost efficiency.

The online version contains supplementary material available at 10.1038/s41598-026-39653-7.