Impact of total hip arthroplasty on multidimensional functioning and sleep in patients with hip osteoarthritis: A prospective cohort study

BackgroundTotal hip arthroplasty (THA) is an established intervention for managing advanced osteoarthritis, offering substantial improvements in pain relief. However, relationship between sleep quality and functional outcomes after THA remains underexplored.ObjectiveThis longitudinal study aimed to evaluate changes in nocturnal sleep quality and daytime sleepiness and their association with functional recovery in 55 patients undergoing primary THA.MethodsPatients undergoing primary THA were enrolled in this prospective cohort study. Nocturnal sleep quality, daytime sleepiness, functional outcomes, and health-related quality of life were assessed preoperatively and at one, three, and sixxs months postoperatively using the PSQI, ESS, WOMAC, HOOS, and SF-36. Statistical analyses included Friedman's test with post-hoc Wilcoxon signed-rank tests and Kendall's tau correlations.ResultsWOMAC, PSQI, all HOOS dimensions, and both SF-36 components significantly improved over time. PSQI scores significantly decreased from the preoperative assessment to the postoperative follow-ups, indicating improved nocturnal sleep quality. In contrast, the median ESS score was 5 at each assessment, and no statistically significant group-level change in ESS was detected (p = 0.996). WOMAC and ESS were significantly correlated at one and six months, suggesting an association between functional recovery and daytime sleepiness at these timepoints.ConclusionsTHA was associated with significant improvements in pain, function, health-related quality of life, and nocturnal sleep quality up to six months postoperatively. No statistically significant group-level change in daytime sleepiness was detected. However, these findings should be interpreted cautiously, and larger prospective studies are needed to confirm them.