Evaluation of hip arthroplasty impact on disability rates (retrospective epidemiological study)

Aim. To evaluate the epidemiological effectiveness of hip arthroplasty and the contingent of patients at the stage of prescribing surgical treatment for coxarthrosis.
Materials and methods. We used a retrospective descriptive study from 2008 to 2024 to analyze the number of HAP patients and patients with disabilities due to coxarthrosis in the Irkutsk region. A crosssectional study of a continuous sample of patients for 2017 (n = 704) was used to analyze the distribution of patients by sex, age, body weight, place of residence, and severity of joint damage in groups with different forms of coxarthrosis: degenerativedystrophic (DDK−56.1 %), dysplastic (DK−30.5 %), and posttraumatic (PTK−13.4 %).
Results. On average, 670 HAP were performed per year, or 3.6 (3.3−3.9) per 10,000 adults; the average disability rate was 7.6 (7.2−8.0), respectively. Over the analyzed period, the number of HAP increased by 2.7 times, and the disability rate decreased by 3.6 times. A weak inverse correlation between HAP and disability rates was revealed in dynamics by years (r = - 0.11, p = 0.68) and a moderate direct relationship (r = 0.27, p = 0.04) when comparing these indicators by territorial units (n = 41). Women predominated in the groups with DDC and DK (60 %), and men in the PTC group (72 %). City residents (69−74 %) and people of retirement and pre-retirement age (Me = 5−57 years) predominated in all three groups. Patients with different forms of coxarthrosis differed in the number of people with disabilities before surgery: odds ratio DDC/DC = 0.65 (0.45−0.95), DDC/PTC = 0.32 (0.22−0.56). Before HAP, 56−79 % of all patients had a disability and more than 96 % had severe joint damage (stages III-IV).
Conclusion. The weak statistical relationship between HAP and disability is explained by the influence of confounding factors, including a high proportion of elderly patients with disabilities before surgery, the presence of patients with contraindications to surgery in the region, and lower accessibility of specialized medical care in rural areas.

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