Patient-related factors influencing the outcome of primary total hip arthroplasty: Age, gender, socioeconomic status, body mass index, and preoperative health status

The number of total hip arthroplasty (THA) operations is expected to increase dramatically during the coming few decades. Many factors can influence THA outcome including those related to the patient and the operation. In this narrative review, we discuss the effect of patient-related factors (age, gender, socioeconomic status [SES], body mass index, and preoperative health status) on functional outcome measures, quality of life and postoperative complication. We used registry-based studies as the main source of data and found the literature to suggest that old age, female gender, low SES, worse preoperative health status, underweight or class III obesity could reduce the patient functional outcome measures and satisfaction while increasing the risk for intra-and postoperative adverse events as well as postoperative mortality rate. These findings are of value when counseling THA patients, whereby modifiable parameters such as low SES, worse preoperative health status, underweight, or class III obesity can be optimized. Other operation-related factors such as surgical approach, surgeon experience/caseload, choice of prosthetic implant, and fixation method are also important for the THA outcome and therefore should be taken into consideration. However, these factors are not included in this narrative review.