Total Hip Replacement and Its Effects on Quality of Life and Psychological Well-Being Among Younger Adults

Total hip replacement (THR) is increasingly performed in younger adults, particularly in South Asia, where avascular necrosis and trauma are common indications. Outcome research has focused on hip function in older patients with osteoarthritis, and little is known about quality of life (QoL), psychological well-being and distress in younger patients. This study examined these outcomes and their predictors among younger adults after THR in Pakistan. In a cross-sectional study, 47 adults aged 18–50 years who were at least 3 months past primary THR were recruited from orthopaedic services in Multan and Lahore. Participants completed the Oxford Hip Score (OHS), WHOQOL-BREF, Ryff Psychological Well-being Scale (18-item) and Hospital Anxiety and Depression Scale (HADS). Data were analysed with Pearson correlations, t-tests, one-way ANOVA and multiple linear regression. Mean hip function was good (OHS 37.09 ± 6.29), yet 46.8% reported at least borderline anxiety and 34.0% at least borderline depression. Overall QoL correlated positively with psychological well-being (r = .51) and negatively with depression (r = −.48) and anxiety (r = −.39). Women reported lower overall QoL (d = 0.67) and markedly more anxiety (d = 1.15) and depression (d = 0.89) than men. Patients 13–24 months after surgery had better QoL, hip function and mood than those at 3–12 months. Hip function (β = .46) and psychological well-being (β = .31) independently predicted QoL (R² = .51). Only 25.5% of patients combined satisfactory hip function with no distress, while 42.6% had both weaker function and distress. Good hip function after THR does not guarantee psychological recovery in younger adults. Routine screening for anxiety and depression, attention to women and the first postoperative year, and interventions that build psychological well-being should accompany orthopaedic follow-up.