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Original article

Impact of geographic location and place of surgery on treatment outcomes of total hip replacement

Authors
  • Slavko Manojlovic orcid logo (University of Banja Luka, Banja Luka, Faculty of Medicine, Department of surgery, Bosnia and Herzegovina)
  • Dragana Dragicevic-Cvjetkovic orcid logo (University of Banja Luka, Banja Luka, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Bosnia and Herzegovina)
  • Nemanja Manojlović orcid logo (District Hospital Gunzburg, Department od Traumatology and reconstructive surgery, Gunzburg, Germany)
  • Zeljko Jovičić (Pan-European University Apeiron Banja Luka, Banja Luka, Faculty of Health Sciences, Bosnia and Herzegovina)
  • Mirko Manojlović orcid logo (Special Surgical Hospital ‘’Dr Kostić’’ Banja Luka, Banja Luka, Bosnia and Herzegovina)
  • Ferid Krupić orcid logo (University of Gothenburg, Gothenburg, Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, Sweden)

Abstract

Introduction: Environmental factors may influence postoperative outcomes and quality of life following total hip replacement (THR). This study investigated the impact of the geographical location of the surgical site, as well as the patient’s place of birth and residence, on treatment outcomes in individuals with artificial hips.

Methods: A prospective study was conducted involving 280 patients (both genderes; mean age 62 ± 8.8 years) who underwent THR due to primary or secondary hip osteoarthritis. Patients were divided into two groups: Group A (n = 64) included individuals who were not operated on in their place of birth and residence, while Group B (n = 216) consisted of those who were born, resided, and underwent surgery in the same geographical location. Outcomes were assessed using the EQ-5D questionnaire (covering mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the Visual Analogue Scale (VAS) for pain, and a VAS-based treatment satisfaction scale, administered preoperatively and one year postoperatively. Statistical analysis was performed using Fisher’s exact test (p < 0.05).

Results: Only 22.9% of all patients underwent surgery in their place of birth and residence, mostly for primary hip osteoarthritis. Preoperatively, Group A reported significantly greater limitations in self-care (p < 0.05). One year postoperatively, Group B showed significantly higher VAS scores for treatment satisfaction (p < 0.05).

Conclusion: Patients who underwent total hip replacement in their place of birth and residence demonstrated better postoperative outcomes compared to those who had relocated.

Keywords: : arthroplasty; immigrants; quality of life

Keywords: arthroplasty, immigrants, quality of life

How to Cite:

Manojlovic, S., Dragicevic-Cvjetkovic, D., Manojlović, N., Jovičić, Z., Manojlović, M. & Krupić, F., (2026) “Impact of geographic location and place of surgery on treatment outcomes of total hip replacement”, Medicinski glasnik 23(1), 227-232. doi: https://doi.org/10.17392/2026-23-01

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Published on
2026-02-27

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CC-BY-NC-ND 4.0