BACKGROUND AND PURPOSE There is little evidence on improvement after revision total hip replacement (THR). Moreover, improvements may be associated with socioeconomic status (SES). We investigated whether changes in Harris Hip Score (HHS) differ among patients undergoing primary and revision THR, and their association with markers of SES. PATIENTS AND METHODS We conducted a populationbased cohort study on 16,932 patients undergoing primary and/or revision THR from 1995 to 2018 due to hip osteoarthritis. The patients were identified in the Danish Hip Arthroplasty Registry. Outcome was defined as mean change in HHS (0-100) from baseline to 1-year follow-up, and its association with SES markers (education, cohabiting, and wealth) was analyzed using multiple linear regression adjusting for sex, age, comorbidities, and baseline HHS. RESULTS At 1-year follow-up, HHS improved clinically relevant for patients undergoing both primary THR: mean 43 (95% CI 43-43) and revision THR: mean 31 (CI 29-33); however, the increase was 12 points (CI 10-14) higher for primary THR. For primary THR, improvements were 0.9 points (CI 0.4-1.5) higher for patients with high educational level compared with low educational level, 0.4 points (CI 0.0-0.8) higher for patients cohabiting compared with living alone, and 2.6 points higher (CI 2.1-3.0) for patients with high wealth compared with low wealth. INTERPRETATION Patients undergoing primary THR achieve higher improvements on HHS than patients undergoing revision THR, and the improvements are negatively related to markers of low SES. Health professionals should be aware of these characteristics and be able to identify patients who may benefit from extra rehabilitation to improve outcomes after THR to ensure equality in health.

中文翻译：

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初次和翻修髋关节置换术后结果的变化是否不同并与社会经济地位的标志物相关？一项为期 1 年的基于人群的队列研究。

背景和目的 几乎没有证据表明翻修全髋关节置换术 (THR) 后的改善。此外，改善可能与社会经济地位 (SES) 有关。我们调查了哈里斯髋关节评分 (HHS) 的变化在接受初次和翻修 THR 的患者中是否不同，以及它们与 SES 标志物的关联。患者和方法 我们对 16,932 名 1995 年至 2018 年因髋骨关节炎接受初次和/或翻修 THR 的患者进行了一项基于人群的队列研究。这些患者是在丹麦髋关节置换登记处确定的。结果被定义为 HHS (0-100) 从基线到 1 年随访的平均变化，并使用针对性别、年龄、合并症调整的多元线性回归分析其与 SES 标记（教育、同居和财富）的关联和基线 HHS。结果 在 1 年的随访中，HHS 改善了接受初次 THR 的患者的临床相关性：平均 43 (95% CI 43-43) 和翻修 THR：平均 31 (CI 29-33)；然而，主要 THR 的增幅高出 12 个点 (CI 10-14)。对于初级 THR，高学历患者比低学历患者提高 0.9 分（CI 0.4-1.5），同居患者比独居患者提高 0.4 分（CI 0.0-0.8），高 2.6 分（CI） 2.1-3.0) 与低财富相比，高财富的患者。解释 接受初次 THR 的患者的 HHS 改善程度高于接受翻修 THR 的患者，并且改善与低 SES 标志物呈负相关。