Does the Presence of Metabolic Syndrome or Its Components Influence Patient-Reported Outcomes After Total Hip Arthroplasty?

BACKGROUND: An increasing number of individuals who suffer from hip osteoarthritis (OA) undergoing total hip arthroplasty (THA) have metabolic comorbidities. Among these, metabolic syndrome (MetS) has been identified as a potential key contributor to OA pathogenesis. Although MetS is also known to increase perioperative risks, its impact on treatment outcomes remains poorly understood. We conducted a prospective cohort study aimed at evaluating whether the presence of MetS and its individual components influences postoperative hip function, health-related quality of life, and mental health outcomes following THA. METHODS: This prospective cohort study included 514 patients who underwent primary THA for hip OA at our university hospital. Patients were stratified into two groups based on the absence (n = 455) or presence (n = 59) of MetS. Patient-reported outcome measures were assessed preoperatively and at one month and one year postoperatively, including hip function, pain , quality of life, and mental health. RESULTS: At one year postoperatively, patients who were diagnosed with MetS exhibited worse scores regarding hip function in several subcategories. Differential effects of the individual MetS components regarding hip function were observed. Dyslipidemia was associated with poorer outcomes, whereas the effects of obesity, T2DM, and hypertension were limited. Importantly, while the proportion of patients reporting yellow flags for depression and anxiety did not differ preoperatively between patients who did and did not have MetS, a higher prevalence was observed in the MetS group at one year postoperatively (MetS: 13.6% versus No MetS: 4.0%, P = 0.006). CONCLUSIONS: We demonstrated that MetS is associated with impaired functional and psychological outcomes after THA, with dyslipidemia as a particularly relevant contributing component. Our findings highlight the importance of an integrated preoperative assessment that combines metabolic risk profiling with mental health screening and optimization to enhance patient outcomes.