BACK PAIN RELIEF AFTER TOTAL HIP REPLACEMENT

Background: Back pain is a common presenting feature in patients with hip arthritis. Hip replacement surgery is performed primarily to relieve hip pain but is known to improve global function. The aim of this study was to quantify the effects of total hip arthroplasty on back pain. Patients and Methods: A prospective study was conducted from 2001 to 2005 at the Victoria Hospital, Kirkcaldy, Fife. A novel body diagram was devised to collect and quantify back pain. Patients were asked to localize their pain on this diagram prior to their surgery and six months later. The patients were also asked to record their level of satisfaction on a visual analogue scale (VAS) and to complete validated functional and psychological assessments (SF-36; Harris Hip Score). Results: Preoperative and postoperative data were complete for 872 patients. Preoperatively, 234 (27%) patients complained of pain in the lumbar region. A low score in the baseline SF-36 correlated with low back pain. At six-month post total hip arthroplasty, the low back pain had resolved in 50% (n=116) of these patients, and resolution of this pain correlated with improved post-operative SF-36 score. The mean postoperative satisfaction score was 8.8 out of a maximum 10 (VAS). Satisfaction correlated with reduced back pain. Conclusion: We describe a novel method of pain assessment in total hip arthroplasty. These data from a large prospective cohort indicate that many patients may expect an improvement in their back pain following hip replacement. This data will be useful in the preoperative counselling of patients considering arthroplasty.