Danish medical journalMay 13, 2014

Outcomes of joint replacement versus joint-saving surgery in younger patients using different measures

Updated Mar 31, 2026

Abstract

One hundred patients undergoing PAO reported improvements in quality of life after a mean follow-up of ten years.

Patients expressed a high willingness to undergo PAO again based on their current experiences.
Significant improvements in joint function and health-related quality of life (HRQoL) were observed after TKA and THA surgeries.
Satisfaction and fulfillment of expectations did not fully align with the observed improvements in knee function and HRQoL.
Preoperative depression was associated with inferior outcomes in specific health measures but not in satisfaction or socioeconomic factors.
Postoperatively, patients remained sexually active after TKA, though a decrease in frequency and negative effects on sexual practices were noted.
THA surgery resulted in significant improvements in joint function and HRQoL, with positive changes reported in female patients' sexual lives.

Simplified

Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma, hip OA is associated with FAI covering three fundamentally different hip deformities, including acetabular dysplasia; all hypothesized to initiates OA development. Where PAO is used worldwide as a joint-preserving procedure in acetabular dysplasia, TKA and THA are the treatment of choice of end stage OA. Traditional main outcomes are clinically objective surgeon-reported endpoints. Patient perceived outcomes are known to differ from these and PROMs are now recommended as the core set of outcomes. When evaluating the outcome in younger patients, this high demanding group can show ceiling-effects of the scores. The overall aim of this thesis was to investigate the consequences of PAO, TKA, and THA in younger patients evaluated by alternative outcomes in relation to satisfaction, fulfillment of expectations, symptoms of depression, the socioeconomic effects, and abilities in sex-life; to improve patient information prior to PAO, TKA and THA surgery.

Outcomes of joint replacement versus joint-saving surgery in younger patients using different measures

Abstract

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