Recovery of physical functioning after total hip arthroplasty: systematic review and meta-analysis of the literature.

BACKGROUND After total hip arthroplasty (THA), patients today (who tend to be younger and more active than those who previously underwent this surgical procedure) have high expectations regarding functional outcome. Therefore, patients need to be well informed about recovery of physical functioning after THA. PURPOSE The purpose of this study was to review publications on recovery of physical functioning after THA and examine the degree of recovery with regard to 3 aspects of functioning (ie, perceived physical functioning, functional capacity to perform activities, and actual daily activity in the home situation). DATA SOURCES Data were obtained from the MEDLINE and EMBASE databases from inception to July 2009, and references in identified articles were tracked. STUDY SELECTION Prospective studies with a before-after design were included. Patients included in the analysis had to have primary THA for osteoarthritis. DATA EXTRACTION AND SYNTHESIS Two reviewers independently checked the inclusion criteria, conducted the risk of bias assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model. RESULTS A total of 31 studies were included. For perceived physical functioning, patients recovered from less than 50% preoperatively to about 80% of that of controls (individuals who were healthy) 6 to 8 months postsurgery. On functional capacity, patients recovered from 70% preoperatively to about 80% of that of controls 6 to 8 months postsurgery. For actual daily activity, patients recovered from 80% preoperatively to 84% of that of controls at 6 months postsurgery. LIMITATIONS Only a few studies were retrieved that investigated the recovery of physical functioning longer than 8 months after surgery. CONCLUSIONS Compared with the preoperative situation, the 3 aspects of physical functioning showed varying degrees of recovery after surgery. At 6 to 8 months postoperatively, physical functioning had generally recovered to about 80% of that of controls.