Quality of Life After Primary Total Hip Replacement: A Prospective Cohort Study from a Tertiary Center in Tanzania

Abstract

Background: Total hip replacement (THR) is a highly effective surgical intervention for patients with end-stage hip disease, leading to significant clinical improvements. However, data on postoperative quality of life (QoL) following primary THR in low-and middle-income contexts remain limited. This study aimed to evaluate changes in QoL following primary THR at a tertiary hospital in Tanzania.
Methodology: This prospective cohort study included 30 adult patients who underwent primary THR at the Muhimbili Orthopedic Institute between July and December 2021. Quality of life was assessed using the EuroQol 5-Dimensional 5-Level questionnaire (EQ-5D-5L), which evaluated specific health domains at baseline, 6 weeks, and 12 weeks postoperatively. Overall health perception was assessed at 12 weeks using the EuroQol Visual Analogue Scale (EQ-VAS; 0–100), with higher scores indicating better perceived health, while patient satisfaction was also evaluated at the same time point. Changes in individual QoL domains were analyzed using the chi-square test for trend, while generalized estimating equations with a multiple linear regression model were applied to identify factors associated with changes in QoL.
Results: The mean age of participants was 53 ± 21 years, with a male-to-female ratio of 3:2. A significant and consistent improvement in QoL was observed across consecutive postoperative assessments (aβ = 34.33; 95% CI: 31.45–37.22; P<.001). Significant improvements were also observed across all EQ-5D-5L domains at both 6 and 12 weeks (P<.001), including mobility (χ² = 43.95), self-care (χ² = 24.37), usual activities (χ² = 35.78), pain/discomfort (χ² = 41.98), and anxiety/depression (χ² = 36.42). At 12 weeks, 24 (80%) participants reported being very satisfied and 6 (20%) satisfied with the outcome. The mean EQ-VAS score was 94.56 ± 9.08 among very satisfied patients and 80.83 ± 10.69 among satisfied patients. QoL improvement and overall health perception were not significantly associated with the examined demographics.
Conclusion: Primary THR was associated with significant early improvements in QoL, along with better overall health perception and high levels of patient satisfaction, irrespective of demographic characteristics in our setting.