Young Patients Have Poor Compliance with Clinical and Radiographic Surveillance Recommendations After Total Hip Arthroplasty

Background: Clinical and radiographic follow-up after total hip arthroplasty allows early detection of wear or failure and is particularly important in the younger THA population given potentially increased demands on implants. The purpose of this study is to characterize patient compliance with follow-up in the young hip arthroplasty population. Methods: Patients ≤50 years who underwent primary THA at a single institution were included. Patients were given verbal instruction to schedule and attend follow up visits at years 1, 2, and 4-to-6 post- operatively. Multivariate analysis using Poisson regression was conducted to identify predictors associated with compliance. There were 344 patients with average age 38.0 years (range, 13-50). 55.5% of the patients were female. Results: There were 178 (51.7%), 101 (29.4%), and 44 (12.6%) patients who complied recommendations at years 1,2, and 4-to-6 years, respectively. Females were more likely to attend 2-year follow up (p = 0.04) then males. Patients with post-op complications were more likely to attend 2-year follow up. (p = 0.01). There was no association between other studied variables and follow-up compliance at 1, 2, or 4-to-6-years post op. Conclusion: Patient compliance was around 50% at 1 year follow-up after surgery and declined substantially over time in this young population. Overall, these data indicate that patients less than 50 years at the time of surgery are mostly noncompliant with follow-up recommendations and may not require routine surveillance or need improved methods of surveillance such as telemedicine or electronic surveys. Level of Evidence: III.