{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:24:56Z","timestamp":1784967896951,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The relationship between comorbidity burden, as measured by the American Society of Anesthesiologists (ASA) classification, and functional recovery after total hip replacement (THR) remains uncertain. This study aimed to clarify whether ASA grade independently predicts postoperative patient-reported outcomes. Methods: We conducted a retrospective analysis of 218 consecutive patients from a prospectively maintained institutional registry who underwent primary unilateral THR between March 2021 and March 2024 in a single center. Patients were stratified into ASA 1\u20132 and ASA 3 groups. The Oxford Hip Score (OHS, 0\u201348) was collected preoperatively and at 1 week, 3 months, and 6 months postoperatively. Between-group differences were assessed, and multivariable linear regression was used to identify predictors of 6-month OHS. Results: Compared with ASA 1\u20132 patients, ASA 3 patients had lower preoperative OHS and longer hospital stay, but both groups showed substantial improvement over time and achieved excellent mean OHS at 6 months. In the adjusted model, higher ASA grade remained an independent negative predictor of 6-month OHS, whereas higher preoperative OHS and BMI were positive predictors. Conclusions: Despite presenting with worse baseline function and requiring longer hospitalization, ASA 3 patients experienced clinically meaningful recovery and achieved favorable 6-month outcomes after THR. Higher ASA status should therefore inform perioperative optimization rather than preclude surgery.<\/jats:p>","DOI":"10.3390\/life16020194","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T13:55:34Z","timestamp":1769176534000},"page":"194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effects of Comorbidities on Outcomes After Total Hip Replacement"],"prefix":"10.3390","volume":"16","author":[{"given":"Hou Hoi","family":"Iong","sequence":"first","affiliation":[{"name":"Department of Orthopedic, Far Eastern Memorial Hospital, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Far Eastern Memorial Hospital, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-5146","authenticated-orcid":false,"given":"Jwo-Luen","family":"Pao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Far Eastern Memorial Hospital, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Chih","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Far Eastern Memorial Hospital, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang-Ming","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0376-6362","authenticated-orcid":false,"given":"Cheng-Tzu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Far Eastern Memorial Hospital, New Taipei City 10617, Taiwan"},{"name":"Department of Mechanical Engineering, Asia Eastern University of Science and Technology, New Taipei City 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: Total hip replacement","volume":"370","author":"Learmonth","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/S0140-6736(18)31777-X","article-title":"Hip replacement","volume":"392","author":"Ferguson","year":"2018","journal-title":"Lancet"},{"key":"ref_3","unstructured":"NICE (2026, January 03). 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