Does THA Improve Social Status Among Turkish Women With Developmental Dysplasia of the Hip?

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dc.contributor.authorMutlu, Tansel
dc.contributor.authorDasar, Uygar
dc.contributor.authorBicimoglu, Ali
dc.date.accessioned2024-09-29T16:03:11Z
dc.date.available2024-09-29T16:03:11Z
dc.date.issued2018
dc.departmentKarabük Üniversitesien_US
dc.description.abstractBackground In traditional societies, patients who reach adulthood with developmental dysplasia of the hip (DDH) may be labeled disabled and may be considered defective, causing them psychologic pain and problems with social interactions. In some patriarchal societies, women disproportionately experience these problems, because they may be seen as insufficient in terms of marriage and sexual intercourse owing to hip-related limitations, and they may be married through arranged marriages to people who also have disabilities. This patriarchal structure limits the ways women can engage in society and may lower their quality of life (QOL). The degree to which THA can improve the lives of women in these specific ways in a patriarchal culture has not, to our knowledge, been studied. Questions/purposes (1) Does THA improve the social standing of young women with DDH in Turkey? (2) Does THA improve QOL of young women with DDH in Turkey? (3) Does THA improve pain and physical function in these patients? Methods This study was a retrospective, comparative study performed at Karabuk University Research and Training Hospital in Karabuk, Turkey, from 2012 to 2017. A total of 217 women with DDH were followed at our center between the study dates. All of these patients were evaluated for inclusion into the study. Among these, 175 women with DDH (aged 20-45 years) were included in the study according to inclusion/exclusion criteria. We offered THA to all patients in whom surgery was technically feasible; 84 chose to undergo THA, whereas 91 declined the procedure. Whether THA had any effects on the study questions was determined by comparison of the following findings at baseline and after intervention. The social standing of patients was assessed through their marital status and proportions of employment and depression; the patients' QOL was assessed with the SF-36 at baseline for all patients and at 1 year postoperatively for those who underwent THA; and pain and dysfunction were evaluated by determination of the proportion of patients who had scoliosis, knee valgus, and knee and lumbar pain. At baseline, patients were not different in regard to all parameters except knee and lumbar pain, which were greater in those who had decided to undergo THA. The SF-36 scores of patients who underwent THA were compared with their postoperative scores as well as with the baseline scores of patients who did not undergo THA. Results In terms of measures of social standing, women who underwent THA appeared better at followup than did the patients who did not undergo THA. Those who underwent THA had higher percentages of marriage and employment and less depression. Regarding QOL, postintervention comparisons revealed that women who underwent THA had higher SF-36 scores compared with the initial results of women who did not have surgery. Compared with preoperative scores, the highest improvements were found in social role function (mean difference 6 standard error [SE] = 58.64 +/- 0.88; 95% confidence interval [CI], 56.91-60.37; p < 0.001) and mental health (mean difference +/- SE = 53.00 +/- 0.86; 95% CI, 51.31-54.69; p < 0.001) subdimensions of the SF-36. Finally, patients who underwent THA had improvements in pain and function as measured by Harris hip score than did patients who did not undergo THA. At initial evaluation, two groups were found to be similar in terms of Harris hip scores (THA: 61.6 +/- 7.4 versus non-THA: 63.7 +/- 7.6, p = 0.066), whereas the THA group was found to be superior at followup evaluation (THA: 83.5 6 6.2 versus non-THA: 62.1 +/- 7.8, p = 0.001). Conclusions Young women with DDH are severely affected by social and cultural norms in Turkey, which is an example of a patriarchal culture. We believe that in this setting, some patients who improve their appearance, gait, and physical function through THA may benefit from a better social perception and higher self-esteem, which may, in turn, increase their QOL and provide more freedom in terms of life choices.en_US
dc.identifier.doi10.1097/CORR.0000000000000403
dc.identifier.endpage1703en_US
dc.identifier.issn0009-921X
dc.identifier.issn1528-1132
dc.identifier.issue9en_US
dc.identifier.pmid30024462en_US
dc.identifier.scopus2-s2.0-85056454307en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1696en_US
dc.identifier.urihttps://doi.org/10.1097/CORR.0000000000000403
dc.identifier.urihttps://hdl.handle.net/20.500.14619/5926
dc.identifier.volume476en_US
dc.identifier.wosWOS:000452513200003en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofClinical Orthopaedics and Related Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectQuality-Of-Lifeen_US
dc.subjectArthroplastyen_US
dc.subjectDiseaseen_US
dc.titleDoes THA Improve Social Status Among Turkish Women With Developmental Dysplasia of the Hip?en_US
dc.typeArticleen_US

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