ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1661819
This article is part of the Research TopicNew Advances in Prosthetic Surgery of Large JointsView all 9 articles
The dual association of serum uric acid with the functional outcomes of patients after hip arthroplasty: 1-year follow-up study
Provisionally accepted
- First Affiliated Hospital of Jilin University, Changchun, China
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Background: Serum uric acid (UA) exhibits dual biological roles as both an antioxidant and a pro-oxidant, yet its impact on functional recovery after hip arthroplasty remains unclear. This study investigated the nonlinear relationship between UA levels and 1-year postoperative outcomes in patients undergoing hip arthroplasty. Methods: In this single-center observational study, 468 hip arthroplasty patients (September 2018–September 2023) were stratified into functional independence (FIM ≥108) and non-independence groups. Serum UA was categorized as low, middle, or high. Functional outcomes were assessed using the UCLA Activity Scale (UCLAAS) and Patient-Reported Satisfaction (PRS) metrics. Restricted cubic splines (RCS) and multivariable regression models evaluated nonlinear and linear associations, adjusted for age, comorbidities, and laboratory parameters. Results: A U-shaped relationship emerged between UA levels and functional independence (p <0.01 for nonlinearity). Both low UA (OR=2.09, 95% CI:1.14–3.85) and high UA (OR=3.74, 95% CI:1.89–7.41) independently predicted reduced functional independence. Secondary outcomes exhibited domain-specific effects: only high UA correlated with poorer mobility (UCLAAS: β=−0.53, p=0.015). Multivariable adjustments confirmed the robustness of these associations. Conclusion: Serum UA demonstrates a dual, nonlinear association with functional recovery after hip arthroplasty, where extremes perturb redox balance and bone remodeling. Monitoring perioperative UA levels and targeting individualized thresholds may optimize rehabilitation strategies.
Keywords: Uric Acid, hip arthroplasty, functional outcomes, nonlinear association, Oxidative Stress
Received: 08 Jul 2025; Accepted: 10 Sep 2025.
Copyright: © 2025 Xia, Han, Sun, Li, Zhu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dongsong Li, First Affiliated Hospital of Jilin University, Changchun, China
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